Ars Moriendi

Hello class. I was absent on February 2nd, and I am sure I missed out on an exciting class discussion. We discussed Chapter 4 in the first book of our course "Bioethics; the Basics." In this chapter some of the topics included clinical ethics, decision making, and medical paternalism. I understand we also touched on the topic of abortion. I would have liked to delve into this a little more; however, I understand one of our midterm project presenters will be reporting on abortion, so I will leave that to him.

I wanted to discuss the topic of Ars Moriendi. A quick refresher; Ars Moriendi is a series of two Latin texts discussing death. Ars Moriendi means "The Art of Dying." The text is written from a Christian point of view and is a result of the Black Plague taking over most of Europe. At the time it is reasonable to say that the vast majority of Europeans were faced with death in their families or friends, and we can consider the text a type of consolidation for the individuals who were afraid of death which, statistically speaking, was almost inevitable.

The following is a summary of the chapters of the "Long version" of the text titled Tractatus Artis Bene Moriendi or The Art of Dying Well Treaty. (This information is from the Wikipedia article available here.)

Ars Moriendi also had various images carved in wood that went along with each chapter

1. The first chapter explains that dying has a good side, and serves to console the dying man that death is not something to be afraid of.
2. The second chapter outlines the five temptations that beset a dying man, and how to avoid them. These are lack of faith, despair, impatience, spiritual pride and avarice.
3. The third chapter lists the seven questions to ask a dying man, along with consolation available to him through the redemptive powers of Christ's love.
4. The fourth chapter expresses the need to imitate Christ's life.
5. The fifth chapter addresses the friends and family, outlining the general rules of behavior at the deathbed.
6. The sixth chapter includes appropriate prayers to be said for a dying man.

The discussion topic available was "Can the medical profession ever fully embrace the concept of Ars Moriendi, the art of dying?"

As a future medical professional I have heard some great lectures from individuals in the field, and I have noticed a commonality between the lectures. Medical professionals tend to leave out discussion of death in their talks. Usually, especially if the audience in younger, there tends to be a question about death, and in these situations the answers are shorter and rushed. It seems that medical professionals are either uncomfortable with the concept of death, or they just don't enjoy talking about it to other aspiring medical professionals.

This is understandable in that many people go into health care in the hopes to save lives and they seldom like to think about the inevitable death of a patient. This is a major flaw in the teachings of health care in that up until medical school individuals go on believing that their career aspiration will not involve much death at all.

As a doctor, or nurse, or EMT etc. death is not something to ignore. Death is something that all life on Earth will meet and instead of evading the topic and trying to genetically distance the human race from it, it would be more beneficial to society as a whole to embrace it. Ars Moriendi served as a consolation to individuals who were frankly experiencing much more death than the average human today probably will within a given time frame. The last few chapters of the text are widely accepted and practiced in that when you are not the one dying, there is certain decorum that you should follow such as; reviewing the positives of the life, not just the end, and prayers or kind words spoken at the end. For religious (specifically Christian) individuals, many of the chapters relate to Jesus and his teachings. These chapters are still highly applicable to those who do not share these beliefs.

Similar to the discussions we had in class about relating moral decisions to a single perfect person as we do with the saying "What Would Jesus Do?" Jesus is but a vehicle for these chapters. Chapter 4 talks about imitating Jesus's life, but if you were not religious you could replace Jesus with any person you personally find moral and "perfect" and the meaning would still last.

Many medical professionals tend to discredit religious teachings and the teachings of Ars Moriendi as merely consolation to death and their job is in and of itself to keep people alive at all costs.

We understand that there are expenses associated with keeping people alive, and we understand that there is emotional chaos associated with it as well, yet our society as a whole still can't seem to move away from this mindset.

Cases show that keeping people alive is very expensive. Although this alone does not discredit the argument that healthcare workers should just prolong life and not well-being, it is important to note that this is a con.

So back to the discussion question, I do think the medical profession can embrace the art of dying (mainly because it is quite possible) but I do not think that this change will come about anytime soon, especially since no one is pushing for it to happen. We continue to perpetuate the idea that modern medicine's only purpose is prolonging life and we (because we are so afraid of death) pressure physicians in to only thinking about life and not the inevitable death.