Don't Spread Your Loved One's Ashes in a Public Place

From Rick Reilly in the Washington Post I know, I know. He was the greatest person to ever live and “deserves” to have an eternal “view” from Yosemite or from the banks of Golden Pond or from the top of the Santa Monica Pier Ferris wheel. Except 3.2 million people die every year in America, and, according to the National Funeral Directors Association, 62 percent ask to be cremated. That’s more than double the rate 20 years ago. And nearly half say they “would prefer to have their remains scattered in a sentimental place.” Which would mean nearly a million incinerated Americans annually coating the sequoias at Yosemite and choking the loons on Golden Pond and sprinkling the churros of Santa Monica. It’s just bad taste. It can also be dangerous.

Witnessing Death

From CNN: "Stories about shared-death experiences have been circulating since the late 19th century, say those who study the phenomenon. The twist in shared-death stories is that it’s not just the people at the edge of death that get a glimpse of the afterlife. Those near them, either physically or emotionally, also experience the sensations of dying."

Emily Levine Embraces Death

Emily Levine had stage 4 cancer when she gave this TED talk. Life is an enormous gift, Levine says: "You enrich it as best you can, and then you give it back."

Sculpture Showing Grief

Melancholy, by Albert Gyorgy

Oliver Sacks Says Goodbye

Oliver Sacks, the neurologist and author, learned that he had terminal cancer. With his characteristic combination of objectivity and humanity, he wrote in the New York Times about his feelings on the last months of his life. I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers. Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.

Study: Cancer and ALS Patients are the Most Frequent Users of Assisted Dying

A new study shows surprising consistency across the jurisdictions that allow medically assisted death. Overall, most people who accessed voluntary assisted dying had cancer (66.5% of cases). Neurological diseases were the second most common (8.1%), followed by heart (6.8%) and lung (4.9%) conditions. We also looked at what proportion of people with each disease accessed voluntary assisted dying versus dying by other means. Even though voluntary assisted dying rates and eligibility criteria vary by location, the rates for specific diseases were surprisingly consistent across regions and time periods. For example, people with amyotrophic lateral sclerosis (ALS) – a rare, progressive, fatal disease that damages the brain and spinal cord – had the highest rate of voluntary assisted dying. People with ALS accessed voluntary assisted dying at a rate nearly seven times higher than people with cancer. Meanwhile, cancer patients were four times more likely to access voluntary assisted dying than those with lung disease, and ten times more likely than those with heart disease. What does this tell us? Cancer and ALS, which appear to be the main reasons people access voluntary assisted dying, have very little in common. But both often cause a more rapid decline in health and a greater perceived loss of dignity than other conditions.

What We Don't Talk About When We Don't Talk about Dying Children

Sarah Wildman writes in the New York Times about her daughter, who died at age 14.

Americans — really, Westerners — are terrified of death. We shy away from it. Death is a problem to solve, not an inevitable part of life. As the grief therapist David Kessler pointed out to me, we once visited the dead in the front parlors of private homes. Now the dead are tucked out of sight, handled by others. A bereaved family is the locus of nightmares rather than the focus of shared support. Nowhere is this more true than with the prospect of a child’s death. Death from illness is seen as aberrant, unusual, terrifying. Death from war, gun violence, abuse is lamentable, awful — separate. Healthy children and teens are largely shielded from the critically ill. Visiting the sick, let alone the dying, is associated with the aged and infirm; a charitable act, but not integrated into our ethos. Clergy members are overburdened. Death in America is a whisper, a shame, an error. Supporting a family through the end of life is delicate. For a child, it is also obscene. In pediatric cancer care, which has an understandable emphasis on cure, advances that have brought families hope can often mean survival rates are downplayed, hard conversations avoided. Death, when it comes, feels like failure. Medical schools rarely insist that students consider the prospect. If doctors aren’t comfortable broaching the subject of death with their patients, the rest of society long ago lost the ability to do so. Ian once quietly mentioned to an old friend that he feared Orli would not survive. She chastised him for giving up hope. He should not say such things. In the time leading up to losing Orli and in the aftermath, we lived on the terrible fault lines between these dynamics. To sit with a family that has experienced, or anticipates, child loss is to know it cannot be made better. And yet there are ways to better how we face it....If a child begins to die, support for both patient and family requires a delicate, coordinated effort between social workers, palliative care experts, oncologists and hospice. Families like ours need both to keep a child comfortable and to brace for worse. Such support is possible. But it takes effort, funding and, perhaps most important, the will to recognize that end-of-life care, and then, inevitably, bereavement care, is essential care in pediatrics. That’s rare. We didn’t find it....I keep coming back to something Wendy Lichtenthal, a lead author of the Lancet paper, told me: Our culture has a profound lack of “grief literacy.”...Everyone, even children, deserves the opportunity to sit with these questions at the end of life. It’s not impossible. But to do so requires us to recognize: It’s not sadness we should fear. It’s regret.