Awakening to Mortality: End-of-Life as Rite of Passage and Pathway to Transformation

Abstract

Many view death as catastrophe, resulting from a cascading failure of biological systems. Fear, denial or unconsciousness results in a medicalized, often institutionalized, approach to end-of-life care. Is dying predominantly a medical event or can it be something more? What would it take to approach end-of-life with intentionality, dignity, and integrity, consistent with beliefs and values? Is healing possible when curing disease is no longer an option? Given the embeddedness of the scientific model in our culture, my thesis “Awakening to Mortality: End-of-life as Rite of Passage and Pathway to Transformation” uses medical terminology for chapter headings -- diagnosis, prognosis and treatment -- as a structure to examine end-of-life. End-of-life is universal and personal, diverse and dynamic. Everyone dies, although each will follow a unique glide path, a personal wheel of fortune. We tend to operate with “heads in the sand” until there is a crisis. My thesis probes the death illiteracy embedded in our culture, where the common approach is flight or fight, ignoring death until symptoms, disease or disaster overtakes us. When forced to face the reality, patients cede authority to doctors who control access to medicine’s vast arsenal of drugs, treatments, and tests and who default towards “always something more.” If humans are more than physical entities, death is a threshold into eternity, rather than an exit into nothingness. Religious belief stems from awareness that there is something greater than us, a force that animates. This spiritual essence pre-dates birth and will persist after bodies expire, although not dissectible during autopsy or observable on radiologic scans. Facing the certainty of death can help transform it. Acceptance doesn't mean death goes away, but acknowledgement of finitude helps clarify and orient how we spend our time. Whether we face and accept mortality, death eventually comes. With courage we can formulate a parting gift, a love letter that lasts and marks the transition from fleeing and fighting to acknowledging and transcending death. Embracing the paradox of mystery and certainty allows more choices over the finale. By acknowledging and preparing, end-of-life can be a time for transformation and blessings, in contrast to the current default: death as ambush, with dying viewed as biological failure, dominated by crisis interventions, and managed by medical professionals.