Explainer
Creed
Death & life
5 min read

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 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? 

Explainer
Creed
Freedom of Belief
7 min read

Nicaragua in peril

Daniel Ortega's power grab fuels persecution.

Jane Cacouris is a writer and consultant working in international development on environment, poverty and livelihood issues.

An balding man with a moustache turns to look at a camera.
President Daniel Ortega.

Nicaragua is the largest country in Central America with a varied and beautiful landscape; towering volcanoes, unique freshwater habitats - Lake Nicaragua is the region’s largest lake - and spectacular marine environments. It has huge potential for development according to the World Bank. But despite this, not only does Nicaragua remain one of the poorest countries in the region but it is caught in the grip of an increasingly totalitarian regime that, according to a recent all-party “Nicaragua Inquiry Report” by UK Parliamentarians, is taking consistent steps to silence democracy and close civic space. This includes human rights violations against religious leaders, particularly within the Catholic Church, as well attacks against political opposition, journalists, scholars and human rights defenders. 

The Ortega dynasty 

President Daniel Ortego returned to power after a break of seventeen years in 2006. Historically a Marxist revolutionary, on his return as President, Ortega threw out his left-wing ideals for more achievable policies. However, in 2012, his politics took a disconcertingly authoritarian turn when he pressured the Nicaraguan Supreme Court to authorise his bid for a second presidential term. And more recently, the Nicaraguan Government, which includes Ortego’s wife, Vice President Rosario Murillo, and several of their nine children in prominent positions, has escalated its campaign of persecution against Christians and the Catholic Church.  

The harassment started in 2018 with a wave of protests across Nicaragua. University students and others took to the streets to demonstrate against the Government’s proposed social security reforms set to increase pressure on workers whilst providing fewer benefits. Ortega, seeing these protests as a threat, responded with violence using pro-government militia and security forces. According to the United States Commission on International Religious Freedom (USCIRF), 355 people were killed and approximately 2,000 injured making it the deadliest and most violent protest since the Nicaraguan revolution in 1979. Following these protests, the Ortega regime then escalated its human rights violations raising concerns internationally. According to the UNHCR, since 2018, neighbouring Costa Rica has hosted over 300,000 Nicaraguans seeking asylum. 

The intimidation and incarceration of clergymen under the Ortega regime in Nicaragua is particularly chilling. It sends a clear message of contempt for God’s priests. 

Persecution of Christians in a Christian-majority country 

The World Watch list is an annual report published by Open Doors, an NGO which supports Christians worldwide, and lists the fifty countries in which Christians face the ‘most extreme persecution’. The latest report shows Nicaragua has risen up the list, from number 50 last year to number 30 in 2024 rankings. Over 95% of the Nicaraguan population profess to be Christian, so this is perhaps a surprising development.  

In 2022, according to the Nicaragua Inquiry, President Ortega was reported to have:

“ordered the arrest of, forced into exile, and verbally attacked priests and bishops, labelling them ‘criminals’ and ‘coup-plotters,’ and accusing them of inciting violence.”  

Most publicly known about is the Bishop of Matagalpa, Rolando Álvarez, who was sentenced to 26 years in prison and later exiled to the Vatican and stripped of his Nicaraguan citizenship. At the end of 2023, the Government arrested and detained seventeen clergymen including Father Silvio Fonseca, an open critic of the Nicaraguan government’s intense persecution of the Catholic Church, and two Bishops who publicly offered prayers for Álvarez before they were arrested.  

In Latin America, culturally there is a reverence for clergymen that differs to what we see in the West. I lived in Rio de Janeiro in Brazil for a number of years and worked with my husband (who is an ordained Anglican priest) in a favela (shantytown) routinely patrolled by armed gangs. When we first enquired about the safety of walking into the community on our own, a local resident assured us that we would be fine, saying “They will never shoot a pastor”. Perhaps that is why the intimidation and incarceration of clergymen under the Ortega regime in Nicaragua is particularly chilling. It sends a clear message of contempt for God’s priests that will strike to the very core of people of faith across the country.  

Over the past year, according to the Inquiry, the Nicaraguan government has also systematically targeted and closed religious organisations that it views as opponents and banned Catholic traditions such as street processions during Holy Week. A journalist was recently sentenced to eight years in prison for reporting on an Easter procession. And perhaps most insidiously, the government has begun to routinely intimidate worshippers, with uniformed and plain clothes government agents visibly monitoring religious services to intimidate clergy and churchgoers.  

Three centuries of religious persecution across the world 

Religious persecution is etched firmly into the history of humanity through to the modern day. From Emperor Nero’s outlawing of Christians across the Roman Empire to the persecution of Muslims and Jews in the Crusades, to the Armenian genocide in Turkey following the First World War to attacks on the Rohingya in modern-day Myanmar.  

Today religious freedom is a hallmark of a developed society, widely considered to be a basic human right. And indeed, the right to freedom of religion or belief is relevant to an array of SDGs (Sustainable Development Goals) aiming to reduce inequality and improve health, education, gender equality, access to justice and climate action. Religious inequalities and discrimination are key obstacles for progress in many of these areas.  

According to UN’s Declaration of Human Rights, “Everyone has the right to freedom of thought, conscience and religion… either alone or in community with others and in public or private, to manifest his religion or belief in teaching, practice, worship and observance.”  

But in spite of this global commitment, and although 123 of the 193 Member States of the United Nations have served as Council members on the UN Human Rights Council (of which Nicaragua is currently a member state), religious freedom is under threat in many parts of the world today. And it takes many different forms. Some countries in the Middle East expressly forbid all religions except Islam whilst others, such as North Korea, do not permit any religion at all. The most recent annual report of the USCIRF lists 28 countries—home to well over 50 per cent of the world’s population—with Governments actively persecuting their citizens for their religious views.  

But is it about religion or is it all about power?   

In Nicaragua, the Catholic Church has power in numbers and therefore an influential voice. When Christians such as Bishop Álvarez, a vocal defender of civic freedoms, began to join other civil society actors in speaking out more critically against the Government, the persecution began. Catholic clergymen have long been targeted for speaking out against authoritarian regimes in other Latin American countries. For example, Archbishop Romero y Galdamez was assassinated in 1980 in San Salvador when he appealed to the military dictatorship to stop the brutal repression of the people.  

But arguably, the Ortega regime’s crackdown on Christians isn’t only because of its fears of the Catholic Church’s power and influence in Nicaragua.  

Having the capacity and choice to believe in God - to have faith - is a profound and powerful characteristic of being human. For Christians, faith in God and Jesus Christ comes first, before any political, social, or economic order. Humans who have a real and living faith in a higher power are defined by it, both individually in how they live out their lives and collectively in how they come alongside others who share the same faith. Perhaps that is why totalitarian regimes that lay claims on the whole person and want ultimate power and control over the collective, are so intent on destroying or co-opting religion.  

Thankfully the international community is on alert. Ortega is being called out for his regime’s spiralling human rights record and persecution of Christians. But there is no room for apathy. In the book of Proverbs in the Bible, it says “Speak up for those who cannot speak for themselves… Defend the rights of the poor and those in need.”  

As the words of the poem, First They Came by Pastor Martin Niemöller presented at the start of the Nicaragua Inquiry Report movingly remind us, 

First, they came for the Communists 

And I did not speak out 

Because I was not a Communist 

Then they came for the Socialists 

And I did not speak out 

Because I was not a Socialist 

Then they came for the trade unionists 

And I did not speak out 

Because I was not a trade unionist 

Then they came for the Jews 

And I did not speak out 

Because I was not a Jew 

Then they came for me 

And there was no one left 

To speak out for me