RESEAR CH
Dying – the final journey Peter Fenwick Hon Senior Lecturer Kings College Institute of Psychiatry, and Department of Neuroscience, Southampton University
The author became interested in end-of-life experiences after one of his own patients described a ‘classic’ near-death experience (NDE). Since then he has collected and analysed more than 300 examples of NDEs and is now documenting what hospice workers and others have witnessed at the end of patients’ lives. Birth and death are perhaps the two most significant landmarks in a human life. And yet while we may make extensive preparations for a birth, we do very little to prepare for death. Or perhaps I’d better phrase that another way. We do little to prepare for the process of dying. Death is another matter. Death has its own rituals – the wake, the condolences, the funeral service and burial. But these are all rituals to mark the end of a life, to help the bereaved acknowledge and come to terms with a death. They do nothing to help the dying person through the dying process. And yet if you ask 10 people how they feel about death and whether are afraid, the chances are that most will say it’s not death itself that they fear; it’s the process of dying and the anticipation
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As a neuro-psychiatrist I worked at the Maudsley, John Radcliffe, and Broadmoor hospitals. But I would say my most compelling (and challenging) research has been into end-of-life phenomena. I have a longstanding interest in consciousness, and in what near-death experiences can tell us about its relationship to the brain, and perhaps to a wider field of non-located consciousness. My wife Elizabeth and I have written a book about the experiences of dying people, their relatives, hospice and palliative care workers. We hope The Art of Dying will help prepare those who are caring for dying people to understand some of the extra-ordinary, but far from uncommon, experiences that come about in the final days or hours of life.
of annihilation. It is this that we should be focused on. Because it is a process. And it should be, and can be, a peaceful process, though it is one that most of us know very little about.
Understanding how we die A peaceful death needs preparation, and most of us are not prepared. We know that death is the shutting down of the body and brain, but we know much less about the dying process and the mental states of the dying. This is largely because we are attached to life, and in our culture death is something to be feared, and therefore ignored. Our attention and our efforts are directed much more towards prolonging life than preparing for the inevitability of death. And so we know very little about it. It is only recently that we have begun to study the subjective process of dying and the many phenomena which have been found to occur around the time of death. There is very little argument now about whether such phenomena actually occur. The argument is usually more about whether their origin is spiritual or organic. But does this matter? The point surely is that experiencing them can transform a process that has always been thought of as fearful into something positive, indeed, joyful. Wholihan (2016) points out that these
experiences are both under-recognised, and cannot easily be explained within a traditional medical model. Yet those who consistently act as caregivers to the dying say they validate such experiences. And Melvin Morse, a paediatrician and researcher found ‘deathbed phenomena to be an integral aspect of the dying process’ which, he says, ‘…should be interpreted as being part of the spectrum of spiritual events that happens to the dying, their families and their caretakers’.
Learning about dying The data in our own study, from 2004 to 2010, came from interviews with 110 carers in one palliative care team, one nursing home and two hospices in England, and three hospices in Holland, plus data collected in an Irish hospice study by Dr Una McColville. Following our TV and radio discussions we also received more than 1,500 emails, data very rich indeed. We found that although almost all the carers we interviewed were aware of and interested in the phenomena they had observed, very few understood their significance. Only the Dutch carers had received proper training in this area, whereas the British were poorly trained and the Irish training was worse. Clearly then, the training of carers – doctors, nurses, palliative care and auxiliary staff – should be a priority.
© Journal of holistic healthcare
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Volume 15 Issue 2 Summer 2018
