On Our Own Terms: Moyers on Dying

On Our Own Terms: Moyers on Dying *Series to air September 10-13 on PBS. Check local listings.

IN LIFE IS A MIRACLE Wendell Berry says that in order to realize that life is an inexhaustible miracle, life must be lived within the thick particularities of "local land" and "local people." In the midst of such a way of life, dying can be acknowledged, even if it remains a painful mystery. Amid such a way of life, we can learn that living and dying are not ours to control. That same lack of control, whether in dying or living, also enables us to discover and embrace the fullness of life and death. When we trust others in community, we discover the significance of giving our lives to others, and ultimately to the Other. In such a giving, there are often miracles.

Our culture, however, tends to make such miracles unlikely. Dying in modern America is frequently messy, frustrating and debilitating--despite and because of medical advances. Many people seem to be less afraid of death than of dying alone, out of control, in intense pain, caught in a technological vise controlled by inattentive technicians.

Can we do better in helping people die well? Bill Moyers thinks so. In a four-part PBS series to be aired September 10-13, "On Our Own Terms: Moyers on Dying," Moyers provides several angles of vision on the end of life. He offers portraits of dying people and their families, hoping to show what "dying well" might look like in our time.

Moyers does not shy away from difficult issues. He focuses on how we can overcome the fear of dying and the denial of death in our culture. Can we really learn to live with dying? He also explores the emergence of "palliative care," highlighting the new attention given to pain management and a more wholistic focus on dying patients' physical, emotional and spiritual well-being. He confronts the debates over physician-assisted suicide and various efforts to control the circumstances of death. Finally, he attempts to address the systemic challenges to providing better care for dying persons and their families, looking in particular at a heroic hospice in Birmingham, Alabama, that is devoted to caring for the working poor and the uninsured.

Many of the virtues of Moyers's work are apparent in this series: he displays a generosity of spirit, a willingness to tackle hard questions and an evenhanded consideration of debates, and he offers poignant portraits of individuals. He has a gift for focusing attention on a critical concern, inspiring conversation and reframing issues and debates. He clearly hopes that this series will stir congregations, community groups and others to discussion, engagement and action about how we die and care for those who are dying. A useful discussion guide and other resources are available on the Web site (www.pbs.org/onourownterms).

The first episode features an undertaker who is also a poet who tells us that we owe dying persons a commitment to "witness." He uses this term in a fairly generic sense, but it has a powerful resonance in a variety of settings: in a hospice program's commitment to telling stories about the person who just died; in a physician's insistence that we ought never to abandon those who are suffering or dying; in a nurse's emphasis on "sharing suffering" by being present with the dying; in the willingness of a hospice nurse to make regular home visits; and, perhaps most important, in the steadfast presence of families, and especially spouses, who bear witness to their love by giving consistent, dignified care and companionship. The examples of committed spouses are so moving that they might well be used with couples preparing for marriage.

The series conveys the hope that the palliative care movement will improve care at the end of life. In situations where there is strong family support and access to adequate health care, palliative care offers a significant opportunity for people to die "peacefully." Palliative care accepts the reality of terminal illness and lets the disease take its course, while making that course as comfortable and "humane" as possible. It both recognizes the limits of technology and draws on significant technological advances in pain management.

In many ways, an emphasis on palliative care is likely to reduce the controversy surrounding physician-assisted suicide. What most people fear, after all, is a death that comes after repeated aggressive interventions have left them helpless and dependent on technology. Indeed, the cases of physician-assisted suicide that Moyers follows in episode three make it clear that most people who contemplate this step are in no rush to end their lives. In the two highlighted instances of people preparing to commit suicide, neither ended up doing so, and both eventually died without too much trauma. While the series carefully avoids taking sides in the debate, the examples suggest that, even in "ideal cases" in which the patients are mentally and physically capable, planning one's own death adds a great deal of unnecessary mental strain to the dying process.