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The lost art of dying well and what we can learn from it today

Living well in order to die well doesn’t simply happen. It takes work. It takes preparation. For All Souls Day, Lydia Dugdale asks if we are prepared for death.

Lydia Dugdale

Lydia Dugdale is the author of The Lost Art of Dying. She is Professor of Medicine at Columbia University and Director of the Center for Clinical Medical Ethics. She is a specialist in both medical ethics and the treatment of older patients. 

A medieval book illustration of a person dying in bed.
A 15th Century ars moriendi, or ‘art of dying’ image.
Basel University, via WikiCommons.

The first of November marks All Saints Day on many church calendars—a day when we Christians remember our martyrs together with all the faithful, both living and departed. On that day, we celebrate that our communion is not simply with one another on earth but is also with all saints of all time, including those who have died.  

For some people, the notion of fellowship with departed saints might be quite exciting. They may have pondered questions about the saints since school assemblies or RE lessons. What was racing through Abraham’s mind when he attempted to sacrifice his son Isaac? What would Mary say a sinless Jesus was like as a toddler? Did Jonah float around inside the great fish, or did he find something on which to perch himself?  

But others among us might wish to skip All Saints Day altogether. Talk of dead saints feels positively medieval, even a bit morbid. Some of us might wonder about our own saintliness—or lack thereof. Could we really experience ineffable joy in an afterlife? Moreover, the very suggestion of an afterlife implies that we ourselves must die—an uncomfortable prospect for most of us.   

Such divergent reactions to the day are revealing. On the one hand, the idea of having saints to remember is to inspire us to live well. They invite us to examine their lives and to grow ourselves in response. On the other hand, they remind us that our days are numbered. And because our days are numbered, we should attend carefully to what it means to live wisely. Saints teach us that if we want to die well, we must live well. 

But living well in order to die well doesn’t simply happen. It takes work. It takes preparation. Which is why this year on All Saints Day it’s worth asking the question: Am I prepared for death? 

Death exists as a paradox for Christians—as something at once lurking and vanquished. 

In the late Middle Ages, the ars moriendi, or ‘art of dying’ genre of literature developed in response to mass loss of life from a fourteenth-century outbreak of bubonic plague. The genre consisted of a number of handbooks on how to prepare for death. Although the earliest text was anonymous, historians believe that its authorship had a connection to the Western Church. After the Reformation, Protestant versions began to circulate, and later handbooks omitted religious particularity altogether. The handbooks grew in popularity throughout the West for more than 500 years. 

This notion of living well to die well lay at the core of the various iterations of the ars moriendi. Early texts warned readers that five temptations lead to dying poorly—temptations to doubt, despair, impatience, greed, and pride. If you don’t want to die a doubting, despairing, impatient, greedy, and proud person, you must cultivate the virtues of faith, hope, patience, generosity, and humility now. But the ars moriendi texts were very clear that virtue did not happen to a person all at once at the end of life. Rather, it required habituation. Cultivating virtues was the work of a lifetime. If you want to be remembered as a person of sound character, a generous person of hope and good will toward others, you cannot delay making such attributes a regular practice. If you are willing to be martyred for your faith—as some of those early saints were—you have got to be sure it is a faith worth dying for. 

I once met a man who had converted from the religion of radical self-centeredness to Christianity. When I asked him why, he told me that of all the world’s religions, Christianity had the best story. As with the martyred saints, it was for him a story worth dying for. And All Saints Day reminds us that in Christianity, death is stranger than you might think. 

Death exists as a paradox for Christians—as something at once lurking and vanquished. Death is the enemy that at long last will be destroyed, and death has already been swallowed up in victory. But you might ask: if death has already been defeated, what remains to be destroyed? And if death will be destroyed, how has it then been defeated? This enigma might partially explain why many regular church attenders are neither physically nor spiritually prepared for death. Researchers at Harvard University have shown that people who describe themselves as most supported by their religious communities are also most likely to reject hospice care and instead to elect aggressive life-extending technology. 

The story goes as follows. Death is an enemy because it suggests rejection of God. From the beginning, God tells our forebearer Adam that he can freely eat of any tree in the garden but one. If he eats from the tree of the knowledge of good and evil, he will die.  Thus, from the beginning, God equates the possibility of human disobedience with the actuality of death.  

Of course, Adam and Eve eat the proverbial apple. And when they do, they don’t immediately die, but they experience a sort of death. For the first time, they become filled with shame and fear. They hide themselves from God. They cast blame. God tells them that moving forward their life will be filled with great suffering. God says to Adam, ‘By the sweat of your face you shall eat bread until you return to the ground, for out of it you were taken. You are dust, and to dust you shall return.’ Disobedience is what Christians call ‘sin’—and it brings death. Sin severs that once harmonious relationship between God and people—a fact that also grieves God, which is why God does not let death have the final word. 

The story gets better. Since we humans cannot possibly undo the drastic results of our disobedience, God becomes fully human in Jesus Christ, so liable to death, while also retaining full, divinity which cannot die. Then, as a human on a cross, he dies as the ultimate sacrifice on behalf of humankind. But this God-Man does not stay dead. After three days in the tomb, Christ is resurrected, defeating death, on what has come to be known as Easter Sunday. Christ’s resurrection functions as a sort of guarantee that all God’s people will one day be resurrected and receive new bodies, that day on which the great enemy of death will be destroyed once and for all. If Adam and Eve brought death into the world, the resurrection hope is that death will be no more.  

This year on All Saints Day we have the opportunity to consider what it means to commune with ‘all saints’ extending back to Adam and forward to future generations. We have the opportunity to study the saints and then examine ourselves. What sort of people are we becoming? Are we living well to die well, as the ars moriendi handbooks teach? And of all the stories out there, which provides the greatest hope in life and in death? 

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16 min read

The eclipse of Christianity and what it means

Reversing spiritual climate change.

Rupert Shortt

Rupert Shortt is an author, biographer and journalist.  

A star burst of light appears to emanate from the eye of a man's head in silhouette.
Gabriel Barletta on Unsplash

The mainstream Churches are faltering – or even at risk of dying out – in their Western and Middle Eastern heartlands. Surveys confirm that only a minority of people in a country such as Britain now claim Christian allegiance. The pattern is being matched in neighbouring societies.  

At the same time many opinion formers preach secularist ideology with a self-confidence shading into dogmatism. Others, unsure of their moorings, feel some residual attachment to spirituality, while being sceptical about the existence of God and other articles of belief.    

Yet, the wisdom taught by the church to its followers, and that is available to wider society, remains intellectually robust, as well as inspiring a transformative global presence. In a major and wide-ranging international study – both a report on the unsettling consequences of secularisation and a defence of a creed too often belittled by its opponents – Rupert Shortt outlines Christianity’s fading profile in the present, but also argues compellingly that Europe’s historic faith remains critical to the survival of a humane culture. 

Where is the world when it comes to explaining what it believes?  ‘Are we secular, Christian or Pagan?’, asked theologian Graham Tomlin, after analysing the Paris Olympics. Is one way of thinking about ourselves about to be eclipsed? 

***

The philosopher Charles Taylor has distinguished between three kinds of secularism. One involves a whittling away of the religious presence in public life. The output of a public service broadcaster such as the BBC reflects this tendency. Secularism can also be seen in a decline of personal religious practice, often coextensive with a retreat from community into individualism. This move has deeper historical roots. Compare, for instance, Bach’s pietistic audiences in Leipzig during the second quarter of the eighteenth century with the Viennese concertgoers reacting as individuals to Beethoven’s music several generations later. Taylor’s third form of secularism rests on the decline of Churches and other faith groups as sources of norms governing personal conduct.  

That Christians are troubled by all three kinds is obvious enough. They should also assume their share of the blame. The Church has plainly fed disillusionment or scepticism at times. But alternative visions should also face scrutiny.  

‘Type one’ secularism amounts to telling people of faith that they are free to believe and practise if they choose, but that their convictions must be entirely transcendent and not at all immanent. In other words, religion is acceptable as an eccentric private hobby because both type one and type two secularism involve seeing communities of spiritual conviction in these patronising terms.  

As to the question of how secularism fills the hollowed-out public square: opponents of ‘public’ religion have little follow-up to Taylor’s third category. This means that their stance can appear self-contradictory as well as essentially negative. To say ‘No one must assert that their views are normative’ – is itself to make a normative statement. Matters appear murkier still on closer inspection. While presenting itself as a beneficial negative grand narrative, secular rationalism finds itself in an uneasy and unresolved relationship with postmodernism, exponents of which dangerously and/or tediously assert ‘alternative’ facts (Donald Trump) or ‘my truth’ (the Duchess of Sussex). If even an atheist standard-bearer such as Nietzsche predicted that the death of God would spawn nihilism and totalitarianism, then Western society may be in far greater peril than is generally supposed. Perhaps – as Rabbi Jonathan Sacks warned – spiritual climate change should be ranked alongside the environmental crisis.   

In demanding that marriage be consensual, the medieval Church also created a climate in which audiences would later sympathise with Romeo and Juliet’s urge to wed against their parents’ wishes.

Little wonder, then, that Christianity is regularly endorsed by the uncommitted as well as by believers, owing to the social blessings that accrue from it. I am not here referring only to goods generated by the prison chaplain or the soup-kitchen convenor or any number of other figures motivated by their faith to minister among the outcastoutcasts. There are also big social trends that we can be barely conscious of, if at all.  

Two simple examples do duty for a bigger picture.  

An important source of our beliefs about individual freedom dating from well before the eighteenth century is the ecclesiastical ban on cousin marriage, which nourished a more trusting world view opposed to clannishness and thus to xenophobia. In demanding that marriage be consensual, the medieval Church also created a climate in which audiences would later sympathise with Romeo and Juliet’s urge to wed against their parents’ wishes.  

Or think of Milton. His defence of free speech, and even his anticipation of the principles of the American Declaration of Independence, are all present in Paradise Lost through the model it offers of genuine mutuality and rational conversation, even against the background of hierarchy and patriarchy.  

Christianity served as midwife to advances including the scientific revolution, egalitarianism and democracy; theology fleshes out political accounts of the good life. These, too, are themes with many variations. Both on conceptual grounds and for reasons linked to their rootedness in communities at every social level, the Churches are better placed to diagnose deeper causes and richer solutions when deploring evils such as high inequality.  

These causes include the decline of working-class men’s wages (the husband-to-wife income ratio correlates strongly with marriage and divorce rates), the bad side of the sexual revolution (married parents are on balance a huge advantage to children and should preferably be the norm), and prohibition (tighter controls on activities including gambling and drug-dealing are usually effective disincentives).  

 

Just as capitalism cannot survive without trust and honesty, so individual freedom cannot last without some internalised moral order. 

Christians and people of Christian heritage also have especially strong grounds for resisting free markets red in tooth and claw. It comes as no surprise that movements including Blue Labour and Red Toryism – along with their counterparts in Continental Europe – do not just present morally charged economic visions.  

They also draw explicitly on Catholic Social Teaching. Even Margaret Thatcher’s biographer Charles Moore lamented capitalism’s failings as far back as 2011: ‘A society in which credit is very restricted is one in which new people cannot rise. How many small businesses could start or first homes be bought without a loan? But when loans become the means by which millions finance mere consumption – that is different. And when the banks that look after our money take it away, lose it and then, because of government guarantee, are not punished themselves, something much worse happens. It turns out – as the Left always claims – that a system purporting to advance the many has been perverted in order to enrich the few.’ 

Moore’s words are quoted in a very valuable essay by Ed West, a Christian conservative whose importance partly derives from his being justly critical of the Tory party. He grants that individualist conservatism, like capitalism, prizes freedom. Yet it was always dependent on established moral codes, and especially Christianity, to encourage good behaviour by force of example. Just as capitalism cannot survive without trust and honesty, so individual freedom cannot last without some internalised moral order. Modern Toryism’s failure is reflected in the appeal to some of atheistic libertarianism, whose exponents envisage ‘a moral bubble which they expect nothing but self-interest to fill’. West draws a piquant lesson. ‘[I]nstead, as we have seen in recent years, once the Church is undermined, the state soon becomes a Church.’ 

As he also notes, the state alone cannot reduce inequality in the absence of greater social capital – a commodity discussed at length in Robert D. Putnam’s bestseller Bowling Alone. West concludes that unless we see a growth in social capital, ‘in the levels of community involvement, in social trust, in virtuous, selfless behaviour – in short, in relationships – inequality will continue to remain high. As Britain has become more individual-obsessed, as institutions such as the family, the Church, the nation and, though conservatives are reluctant to include them, trade unions have become weaker, this reduction in social capital has disproportionately harmed the poor.’ The same applies to other Western societies of course.  

West doesn’t just flag up the undoubtedly grave social problems caused by mass fatherlessness. He also emphasises the converse: that contemporary economies make it increasingly difficult for the proverbial ‘working man’ to support a family. The period known in France as les trente glorieuses (1945–75) was well known for exponential economic growth. That time has passed. A jettisoning of state socialism in China and India since the 1980s inevitably means that the centre of economic gravity has shifted back towards Asia for the first time in 500 years. This in no way discredits West’s message, however.  

A more than simply ‘cultural’ Christian commitment could include the following additional elements. There is never going to be a point at which active church members can stop thinking, praying and acting for justice. A follower of Christ must be abidingly restless at some level. After making himself a thorn in the flesh of the Third Reich, the Protestant giant Karl Barth said that Christians are always going to be unreliable political allies. In other words, they will want to confront the powers that be with awkward questions and should never feel happy about signing up to a complete package. A preacher I once heard put it as follows. ‘At the end of the day, what matters most is that sense that the deepest reality in social life boils down to some fundamental issues. Are we acting as a society, as individuals, out of a love of self that leads to forgetting God, or love of God that leads to forgetting self?’ 

The Church is therefore not a triumphant illustration of what it looks like when social and cultural challenges are resolved. Rather, he added, it is an illustration of what it’s like when people turn to the big questions we confront again and again in repentance and trust, ‘and try to live out a life in which we’re not constantly at war with one another, individually and collectively, and are looking for what it is that we can recognise as allowing us to flourish side by side under the God whose concerned love is for all of us.’ 

To me, this freedom of conscience and speech is perhaps the greatest benefit of Western civilisation. It does not come naturally to man. It is the product of centuries of debate within Jewish and Christian communities. 

 

Ayaan Hirsi Ali

Granted the viability of these reflections, it is perhaps less surprising than may at first appear that the Somali-born ex-Muslim and feminist campaigner Ayaan Hirsi Ali should have announced in late 2023 that she now counted herself a cultural Christian. Made public in an article for the UnHerd website, the move was nevertheless eye-catching given Hirsi Ali’s past status as an ally of Richard Dawkins and other New Atheist campaigners. She posed two questions. ‘What changed?’ and ‘Why do I call myself a Christian now?’ Her answers are worth setting out at some length.   

Part of the answer is global. Western civilisation is under threat from three different but related forces: the resurgence of great-power authoritarianism and expansionism in the forms of the Chinese Communist Party and Vladimir Putin’s Russia; the rise of global Islamism, which threatens to mobilise a vast population against the West; and the viral spread of woke ideology, which is eating into the moral fibre of the next generation. 

We endeavour to fend off these threats with modern, secular tools: military, economic, diplomatic and technological efforts to defeat, bribe, persuade, appease or surveil. And yet, with every round of conflict, we find ourselves losing ground. We are either running out of money, with our national debt in the tens of trillions of dollars, or we are losing our lead in the technological race with China. 

But we can’t fight off these formidable forces unless we can answer the question: what is it that unites us? The response that ‘God is dead!’ seems insufficient. So, too, does the attempt to find solace in ‘the rules-based liberal international order’. The only credible answer, I believe, lies in our desire to uphold the legacy of the Judeo-Christian tradition. 

That legacy consists of an elaborate set of ideas and institutions designed to safeguard human life, freedom and dignity – from the nation state and the rule of law to the institutions of science, health and learning. As Tom Holland has shown in his marvellous book Dominion, all sorts of apparently secular freedoms – of the market, of conscience and of the press – find their roots in Christianity.

Hirsi Ali had had an epiphany around the centenary of Bertrand Russell’s ‘Why I Am Not a Christian’, a lecture later published under that title. 

 I have come to realise that Russell and my atheist friends failed to see the wood for the trees. The wood is the civilisation built on the Judeo-Christian tradition; it is the story of the West, warts and all. Russell’s critique of . . .  contradictions in Christian doctrine is serious, but it is also too narrow in scope. 

For instance, he gave his lecture in a room full of (former or at least doubting) Christians in a Christian country. Think about how unique that was nearly a century ago, and how rare it still is in non-Western civilisations. Could a Muslim philosopher stand before any audience in a Muslim country – then or now – and deliver a lecture with the title ‘Why I am not a Muslim’? In fact, a book with that title exists, written by an ex-Muslim. But the author published it in America under the pseudonym Ibn Warraq. It would have been too dangerous to do otherwise. 

To me, this freedom of conscience and speech is perhaps the greatest benefit of Western civilisation. It does not come naturally to man. It is the product of centuries of debate within Jewish and Christian communities. It was these debates that advanced science and reason, diminished cruelty, suppressed superstitions, and built institutions to order and protect life, while guaranteeing freedom to as many people as possible. Unlike Islam, Christianity outgrew its dogmatic stage. It became increasingly clear that Christ’s teaching implied not only a circumscribed role for religion as something separate from politics. It also implied compassion for the sinner and humility for the believer. 

Yet I would not be truthful if I attributed my embrace of Christianity solely to the realisation that atheism is too weak and divisive a doctrine to fortify us against our menacing foes. I have also turned to Christianity because I ultimately found life without any spiritual solace unendurable – indeed very nearly self-destructive. Atheism failed to answer a simple question: what is the meaning and purpose of life? 

Christianity’s radical reservation about ‘the world’ of ‘principalities and powers’ springs from a sense of chronic brokenness in the human condition.

Many assumed that Hirsi Ali’s move amounted more to an acknowledgement of Christianity’s role in securing social progress than an acceptance of the Nicene Creed – though the situation is evidently dynamic. She also writes of learning about the faith bit by bit as she attends church Sunday by Sunday. In any case, although some more orthodox figures responded a bit sniffily to the article, ‘cultural’ Christianity has a long history. Churchill is well known for describing himself as a flying buttress – namely supporting the structure from outside. His leanings are widely copied.  

Since her move towards cultural Christianity, Hirsi Ali has started attending church regularly and was recently baptised.* Like other Christians, then, she may now want to push a bit further. The grounds for doing so are philosophical as well as theological. Philosophical, because conserving the Judeo-Christian cultural inheritance should not be confused with ancestor worship. These traditions can and should be justified as expressions of our truth-tracking pursuit of the good, the true and the beautiful. I follow a line extending back to St Augustine and beyond in giving a Christian framing to these Transcendentals. We are naturally not obliged to do so. Latter-day Platonists and perhaps Stoics will share a commitment to allied metaphysical principles. What certainly does remain necessary, however, is a commitment to objective standards of reference, side by side with a universal idiom for articulating them.  

And the foundations are theological, because Christianity is not ethics misleadingly encased in archaic myth. It is about faith and hope in a journey from exile through a wilderness to springs of living water. Karl Barth’s political stance sketched above is biblically based. Christianity’s radical reservation about ‘the world’ of ‘principalities and powers’ springs from a sense of chronic brokenness in the human condition, and the corruption of even our noblest ideals. In short, we are marked by original sin, which in turn generates a quest for healing that is re-presented in liturgy. The Sermon of the Mount stands out for me with particular force here. In David Martin’s unpacking of it, Jesus preaches against a horizon of beatitude and promise. The sermon ‘asks how you stand, how you are placed when it comes to receiving, giving and making gestures of reconciliation and inclusion’. Right at the heart of Christian belief stands ‘the blood offering of the Blood Donor, and our loving communion with the Donor.’ Like all pastors worth their salt, Martin brought out the importance of Trinitarian as well as incarnational belief. In holding that the source of all created reality is itself an eternal exchange of mutual self-giving, Christians can infer among much else that differences need not lead to conflict or antagonism but can coexist in harmony and find expression in creativity. 

Perhaps the most searching response to Ayaan Hirsi Ali came from Jacob Phillips in The Critic magazine. Aged 25, he converted to Christianity soon after the turn of the millennium while working in the City of London. His office ethos amounted to ‘rough-edged Thatcherism’ – the aim was to make as much money as possible in the shortest possible time. Phillips’s colleagues read Zoo and Nuts  (then very popular but now defunct lads’ mags), while ‘popular culture had begun slipping into a level of pornification impossible to imagine just a few years previously’. Employees would disappear into toilet cubicles to snort drugs on Friday afternoons.  

Leaving the office to attend Mass during the lunch hour – as Phillips did regularly after his reception as a Catholic – thus felt counter-cultural. ‘Mammon lay slain’ at the church door. ‘In the first few minutes kneeling in the pews, there’d be a radical decentring of all the values the world held dear. I’d return to work feeling reorientated by the uncontrollable centre of human life – the miracle of being restored to our origin out of nothing, after accepting the dereliction and dismay of the world.’ 

Christian radicalism continues to exert a strong pull on Phillips.

‘I read “when Christ calls a man, he bids him come and die” from Dietrich Bonhoeffer, or St Theresa of Lisieux saying, “I desire only to suffer and be forgotten.” As my colleagues raged through the City’s bars on Friday nights, I would pray a line from Psalm 88: “You have taken away my friends, and made me hateful in their sight.”’

He quit his job a year later to study for a degree in theology.  

The move felt more subversive then than it might do in the 2020s. Churchgoers themselves – not just practitioners of civic religion, but also some members of an older liberal generation probably too accommodating of secular fashions – can be among those most surprised to discover the continuing potency of gospel teaching. Like Martin, Phillips sees that the civilisational benefits of Christianity are only by-products (albeit important ones) of faith itself.  

Faith is . . . uncontrollable, and it is just as active in despair and dereliction as in the moments of great historical achievement. If your Christianity promises to improve life in a worldly sense, it probably isn’t that Christian. 

The apostles didn’t lay down their nets to become fishers of self-fulfilment. The mystics didn’t emaciate themselves through fasting to defend our freedom of speech. The martyrs didn’t die for the good educational outcomes of stable families. At the centre of anything purporting to be Christian must always be the . . . disruptive reality of lives being lived, and societies being led, in ways which are not of our choosing.

These thoughts can be put in a nutshell, as well as endlessly elaborated. The brief version should include an avowal that our lives have a telos or goal. Christianity’s eclipse matters because the Church is the sturdiest vessel for the preservation of values without which civilisation will perish. And because Christian teaching goes further in maintaining that our human search for love and joy is at one with the order and purpose of the world as God’s creation.  

Janet Soskice, one of my wisest teachers and a thinker to rank alongside Taylor, sums these thoughts up memorably with the simple comment that Dante was right. ‘In the end,’ she adds, ‘it is love which moves the Sun and the other stars, and which draws us on in our social and moral lives. We just need to be able to see it.’  

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