Medical Ethics Part 5 (Death)

Down the Wormhole

Episode 89

Despite the fact that all living things die, most people refuse to talk about it until it directly affects them. That's too bad, because planning for death can make living so much more vibrant. In this episode, we talk about physician assisted dying, guerilla funerals, the importance of ritual, and the nature of life itself.

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produced by Zack Jackson
music by Zack Jackson and Barton Willis

Transcript

This transcript was automatically generated by www.otter.ai, and as such contains errors (especially when multiple people are talking). As the AI learns our voices, the transcripts will improve. We hope it is helpful even with the errors.

Zack Jackson 00:05

You are listening to the down the wormhole podcast exploring the strange and fascinating relationship between science and religion. This week our hosts are

Adam Pryor 00:15

My name is Adam Pryor. I work at Bethany College in Lindsborg Kansas. I hope that when I die, someone will put me in the mushroom burial suit invented by Jim Ray Lee

Ian Binns 00:27

Ian Binns Associate Professor of elementary science education at UNC Charlotte. And see I would be cremated and put into the hilt of the first real lightsaber.

Rachael Jackson 00:41

Rachael Jackson Agoudas, Israel congregation Hendersonville, North Carolina, and after I die, I want a traditional Jewish burial. So buried in some sort of decomposing box, I don't really care if it's pine or cardboard. And, yeah, just to be buried in the ground, nothing just simple.

Zack Jackson 01:06

Zack Jackson, UCC pastor and Reading Pennsylvania, and when I die, I want to be composted.

Rachael Jackson 01:13

Kendra Holt-Moore, PhD candidate at Boston University, and when I die, I want half of my body to be pressed into a gemstone that will become an heirloom of my family. And the other half of my body will be buried in one of those tree pods that grows into a forest. I can't remember the name of the person who invented these tree pods. But it's a similar idea, I think, to the mushroom suit, but you become a forest of death.

Adam Pryor 01:44

That is oddly specific.

Zack Jackson 01:48

Yeah, yeah. It's a wonderful story in Greek mythology about that,

Ian Binns 01:52

with the force of a point out that all of you all y'all came up with something? Like somewhat reasonable. I mean, I just wanted to play. How cool would that be, instead of being like, displayed on someone's, you know, mantle in a box, or an urn that can be displayed as a lightsaber hilt?

Zack Jackson 02:14

There you go. Or I can just give my carbon back to the earth that sustained me. Yeah, see, I

Ian Binns 02:20

mean, that's probably what will happen. But I wanted to fantasize

Adam Pryor 02:23

I'm hung up on the gemstones.

Ian Binns 02:26

Okay. Kendrick, Tell us. Tell us about

Zack Jackson 02:29

death. And which, which half of you is going to be a gemstone I want? I'll leave that up to

02:36

the left half.

Adam Pryor 02:37

Is it like? Like, certain parts? Are you? The person chopping you up? I thought they would like, without the ashes. That's not what I envisioned no harm. And how about foot?

Zack Jackson 02:59

That's absolutely the way this has to go. Now. It's like, Don't cremate and turn you into a diamond. Let's just take like your arms or legs and squish them.

Ian Binns 03:08

Yeah, let's just squeeze them all together. You're going to create a gemstone,

Kendra Holt-Moore 03:12

whichever parts would make the best gems.

03:22

Oh, yeah. I guess

Rachael Jackson 03:28

it's as good as it's gonna get. Um, yeah, so we're talking about death today. And there's so much that we could talk about. So let me just say that. I think that death is a pretty fun subject to talk about, mostly because a lot of my own work is about at least implicitly. So it's just so a lot of the stuff that I do comes out of this social psychological theory called terror management theory. And that's terror. Not what people often Yeah, terror. Some people hear me say that and they think I am saying Tara, marriage management theory or like Tarot management theory. But no, it's terror. t e r, r o r, like, you're terrified.

Ian Binns 04:19

I do like to Taro. Sounds kind of cool.

Rachael Jackson 04:24

Yeah, that's a different thing. But terror management theory is a theory that was first proposed in the 80s by a social psychologist, and the whole there's, there's a lot that has been done over the last several decades on it. But the basic idea is that when people are primed to think about death, or they're exposed to some kind of trigger that causes them to reflect on death, and there are explicit and implicit ways of doing this, but basically, these Death triggers or what they would call mortality salience triggers. And they they make us more defensive. And these defense mechanisms can look a lot of different ways. But the basic idea is that like, people don't want to die, whether we're talking about physical death, or even like, a more like metaphorical figurative kind of death. So think, you know, apart from dying in your body, maybe you're also another kind of death would be like, total social isolation and exclusion, that's the kind of like social death. So there's something that is not, we're not just talking about, like physical death, even though that's a huge part of it. But also, you know, a kind of ego death, if you will, where, what it means to be human, the connectedness we feel in community, like there are ways of dying, that disconnect us from those pieces of what it means to be human as well. So anyway, terror management theory is something that touches on all these different kinds of death, and shows how people become more defensive of the things that are meaningful to them, or the things that make us feel like we have a purpose and a sense of significance in the world. And when we don't have those things, those ties of significance, those like foundational building blocks of meaning and community and purpose, that we are a lot more vulnerable to, like psychological dysfunction, and other forms of dysfunction and even death. And so there's, you know, all kinds of ways of, of testing this, but just to give like, one example of what this means is, there was a study years ago, where a group of researchers, they, they took a group of Christians, and they divided the Christians and half and half of the Christians were exposed to some kind of mortality salience, or like death trigger. And usually, that's a couple of questions where you're being asked explicitly to reflect on what you think about death, like what you think will happen to your body when you die, stuff like that. And then the other half of the Christians, were not asked those questions. And then all of the Christians were brought back together and given a series of questionnaires in which they were asked to evaluate an out group, in this case that outgroup was another separate group of Jewish people. And what they found was that the Christian group who had been exposed to the mortality salience trigger, that they had a slightly harsher evaluations against the the Jewish group, than the the half of the Christians that were not exposed to a death trigger. And so this is like, first of all, just say, this has nothing to do with like, like, implicit, like, inherently being like Christian or Jewish, like you could have put in like, Canadian American, like any kind of like identifier. But this goes to show that, like, religion is often a very, like salient and important and strong form of identification for people. But what this showed was that, you know, whenever we're threatened in some way, with these, like ideas of data that we really, we want to like, strengthen our in group markers, and we become a little bit more suspicious of ideas or people or communities that are different from us, or that threaten what we see as like the nature of the universe, the order of the cosmos. And so this is just like one example and hundreds of studies that have been done at this point that that show this idea, and like I said, you could do this with a number of things, but I chose the, the religious example because of, well, what are conversations usually turned to so the point though, is just to say, like, we, as people, we think about death a lot, and we a lot of what we do in our lives, we're trying to like, make, you know, make meaning and like find a sense of belonging in the world, and that death is just like part of being human. And it's something that at some point, we will have to think about more explicitly, and have to really reckon with and so that is just like some background I guess, into like, why this this last episode. In our What is the serious medical ethics? Is that loosely That is correct. But yeah, just to give a little background unto like, how to like orient to this conversation about like the nature of death, the concept of death and how it how it can be a really powerful motivator of, of human behavior. And so, yeah, I guess, like one of the, one of the stories that I was thinking about, and this is sort of transitioning to a slightly different direction than what I was just talking about, but I was thinking a lot about the Death with Dignity movement, this week. And that, for those who don't know, like, there's a lot of, I think, every year, there's still like, ongoing discussion and debate about how this looks in policy. But the state of Oregon was the first state to implement a policy, I can't remember the year, if anyone knows that off the top of their, their head, for Feel free to say, but we can find that later. But they, Oregon was the first state to implement a policy in which people who were terminally ill were are able to ask for a lethal dose of medication to end their lives, so that they don't have to suffer. And that they, you know, the The purpose of this policy was to give terminally ill patients a sense of control, and a sense of, you know, dignity and normalcy in their last days with family. And so the, the story that I had read long ago was a woman named Brittany Maynard, or main art, I'm not sure exactly how to say her name, but she, she died by this voluntary lethal dose of medication on, I think, in 2014. But before that, she had been diagnosed with an aggressive brain cancer, and she was 29. And she and her husband, you know, they were young, and there, they knew that there was nothing that was going to save her. And brain cancer is, you know, just, it's a, like a horrifying thing to go through, and would lead to a lot of suffering and a lot of deterioration in her body and in her, like, mental capability and personality, and she didn't want her family to have to watch her suffer that way. And she didn't want to, sorry, my mind's going on here. And she had didn't want to suffer that way. And so she and her husband established residency in Oregon, so that she could participate in the death with dignity. Act. And so anyway, this, this has led to a lot of conversations, and in a lot of different like religious communities and, and medical communities about like, what this means, like, what are the implications of something like this? And this is just like one example in, in medicine have like, conversations about death. Like, there are other things that, you know, we could talk about, like, defining what death even is, because that has changed over the years as well. But I was thinking a lot about this conversation, because there's something that seems almost like paradoxical I guess about it, you know, and I think that's part of what the controversy brings out is, we feel like, you know, especially many people from religious communities who say, well, all life is sacred, and we should, you know, stand by the sanctity of human life and things like that. And so how does something like the Death with Dignity act, violate that principle, or even, you know, uphold it? And, and so, I just wanted to, like, make that our example and to maybe see, especially like, the clergy in the room, what if, what this has looked like in your communities, if this is something that you've come across, and how that conversation has, has played out? Because when I think about it, I, I think a lot about how, you know, and in, you know, like my academic work, what it means to look at something like the death of dignity, like assisted suicide issue and how that is a way of, like fighting death, or, like, Is it a way of fighting death or giving into death? I think that's sort of the Controversy here and that there's like, a lot of different ways to sort of analyze and interpret what this very personal decision actually means. And it's just so interesting because you, you can, you can really understand it, I think from several different angles, that it, it's like a fight against the suffering and the humiliation that the dying process can bring. So that you, you know, maybe like, remain in your friends and family's memories as a vital, like healthy person. Whereas other people see it as like maybe as a kind of giving up. And it's just like, so it's such a personal issue. And so, so yeah, that's, that's what I wanted to just sort of set on the table to get us get us going.

16:02

These are really great things that you're talking about Kendra. And I will say that I have taught about dignity and death from a Jewish perspective. And I want to throw in a couple couple, you post a couple of dichotomies. And I think there's far more there, there's several others dichotomies as well. And so just want to look at that, when we think about death, dignity in dying, right, which is a better terminology than physician assisted suicide. Right, we're giving somebody dignity? Well, we asked, we have to ask ourselves the questions that in the last 100 years, we have progressed and our medical intervention in such incredible ways that we prolong people's lives. Right, I mean, that's vaccines, antibiotics, surgery, right, just simple things like that, that have prolonged people's life. So from from my perspective, there's really this question of our way of prolonging suffering and the suffering part of life and what part of it right so those those pieces and I, I feel I have to live into the roles that I have set up for myself, and I want to share a story. If that is okay, this comes from comes from Tom but of course, because that's where I like to quote a lot of and everyone wants the full full citation Babylonian Talmud traffic to boat page 104 eight. And this, this will lead into part of the conversation that I was thinking. I made servants of Rabbi Yehuda hanasi went through the roof and said, the upper realms are requesting the presence of Rabbi Yehuda hanasi. And the lower realms are requesting the presence of Rabbi Yehuda hanasi. May it be the will of God that the lower world should impose their will upon the upper worlds. However, when she saw how many times he would enter the bathroom, remove his phylacteries exit, put them back on and how he was suffering so with his intestinal disease, she said, may it be the will of God that the upper world should impose their will upon the lower worlds, and the sages, meanwhile, would not be silent, meaning they would not refrain from begging for mercy so that Rabbi Yehuda hanasi would not die. So she took a jug through it from the roof to the ground. And due to the sudden noise, the sages were momentarily silent and refrain from their begging of mercy. And at that moment, Rabbi Yehuda hanasi died. So we use this and modernity we use this story to say, Who are we doing this for? Who are we prolonging the life and therefore the suffering for? Is it because we can't bear to let this person die? Or is it because that's what is necessary? So that's, that's one way we use this story. The second way we use this understanding is from an ethical standpoint. medical ethics has this idea of personal autonomy, resources, my use of adequate resources and do no harm non maleficence. If a person is clearly suffering, is it not the job of the physician to do no harm? Right? So we really ask we really have to under Stand are we causing harm by allowing someone to live? So having said that, a couple of case questions that I was thinking about, if there is a person who has, you know, the example that Kendra gave, right? So this woman has a brain tumor. Let's say she now develops completely Incidentally, just randomly has nothing to do with the brain tumor, she develops severe bronchitis that turns into aspirational pneumonia. Right? Do you treat the pneumonia? Not rhetorical. Do you treat the pneumonia? Not we're not again, we're not touching the brain. We're not doing anything, do you treat pneumonia?

Ian Binns 20:50

I would still defer to the patient's wishes. I said, if the patient says, Hey, I don't want you to treat my pneumonia, and then argue against that? Well, probably, especially if I've made the decision that I'm going to continue on with my life as long as I possibly can until the cancer finally gets me, then yeah, I would treat it

Zack Jackson 21:20

as a doctor, you do what the patient wants. But if it were me, I don't know if I would, I might see that as a grace. Pender Adam,

Rachael Jackson 21:33

I guess it depends how much time I thought I had left. But I'm inclined to answer I guess similarly to to Zack, that maybe I would if I, if I still had like a good bit of quality of life left. So yeah, I guess I would lean more towards Yes.

Adam Pryor 21:57

I don't have enough information to decide. No, I do like information you have. So no, like. So like, what I think about are the answer I might give to that question look very different when I am 29 versus 39 versus 49. versus 59. It looks really different depending on what my familial situation looks like. And to me, it also looks really different based on the this specific type of brain cancer and its prognosis. So there's, there's a spectrum of I might answer yes or no.

22:44

could go either way. What about you, Rachel? Either way, if I were the patient, in this case, I would not treat the pneumonia.

Ian Binns 22:55

Can you explain why?

22:57

Yeah. If I know I'm going to die soon, right? We're all going to die. But if I know that I'm going to die, and it's going to be a terrible dying experience. I wouldn't want to leave that for anyone including myself. Pneumonia is considered old man's friend. Right?

Zack Jackson 23:19

Right. That's why I mentioned it. I see it as a grace. Yeah, but I would still want it. Not to be cured. But I feel like I would want some kind of comfort, at least in it. Recently drowning

23:33

you aren't? Yeah, you I mean, that's the difference, right? You can cure most people. I shouldn't say most times, pneumonia has the ability to be cured. Right. It's not an automatic death sentence if you get pneumonia, but there are plenty of symptom relief things that you can also take, you know, also just like, have enough morphine that you don't care for feel any of it. I bring this up because there are real life examples. Right there real life, right? There's a there's a response that that we look at responses, the Jewish way of saying, Hey, I have this question that doesn't actually have an answer. Hey, rabbis, can you give me an answer, where it talks about a 95 year old woman who has Alzheimer's, severe, severe Alzheimer's? And they compare that to a 16 month old who has severe cannabis disease? Right, both of them will die within the year. What do you do with them? Does their happiness matter does how long they live matter? What matters when we make these decisions? And who is making these decisions? Right in the case that Kendra provided for the death and dignity, the patient themselves is making the call. Oftentimes, when we are faced with questions like this, the patient themselves is not the one capable of making that call, for one reason or another again, in terms of the death, they did In Oregon and Washington, Oregon, I just looked at my notes that was 97. Washington was oh nine. So both those two states habit, and in those cases, the patient themselves must be the one it cannot be a guardian. And there's lots of doctors involved and psychologists and it has to be a hospice situation of six months or less verified by multiple doctors. I mean, it's really above board. This is not the 1990s Kevorkian questions, which is a different question entirely. But I know that that's clouded. Those of us that remember those years very differently than these laws in Washington and Oregon, Washington State and Oregon? Um, I think it's, I think it's all of those pieces. And then when we look at the question of what are we doing for prolonging life, if someone you know, what is death? And I so let me just answer that real quickly. I know I'm jumping all around. And for our listeners, I apologize that I'm just sort of chunking my statements here, I unfortunately will have will have to exit and leave this wonderful conversation. So I just want to put in a couple more thoughts.

Zack Jackson 26:08

Without Rachel, it's gonna turn dark,

26:10

it's gonna get dark, it might turn it gets dark. So I'll have to listen to your statements when they come out, then.

26:22

Um, what what do we classify as death A long time ago, it was when you stopped breathing, and then it became when you stopped having a heartbeat. And then it's when your brain ceases to have brainwaves. Right. And that's where that's where we're at now, is brainwave death. So if your heart is still beating, your body is technically living alive. But your brain is not and cannot be, we don't have a way to resurrect that. So what do we understand death to be. And this is where I see hope in our society. This is where I'm hoping we will get to go that rather than asking these questions of being that we're removing the sanctity of life, we're redefining what life can be. So here's the optimism that you're just going to have to hold on to for just a little bit, because I can't, I can't end the episode this way, because I'm not going to be there. But it's optimism that rather than being afraid of death, which is what so much of our society is dealing with. And as a clergy person facing one's mortality is a question that we face a lot. And I know other third year the same way, and recognizing that, you know, bring on the Lion King, it's the circle of life, it's the circle of life where we're really looking at life, and that death is just a part of that. So getting down and drilling down, what are the things that we're afraid of, and it's, it's often a fear of difficulty and dying, or it's often a fear of an afterlife for some people. So that's not which it's not just death that we're afraid of, in our society with all these medical techniques, we have the ability to, to say, Okay, now we have the control. Right, we have the ability to Yeah, how are we using that control? How are we taking ownership of ourselves and our life, which includes this portion of?

28:27

So that's all for me.

28:33

Good luck.

Zack Jackson 28:55

I'll jump on the religious aspect, because the United Church of Christ actually has made Yeah, you have statements about this topic? Because of course, we have

Ian Binns 29:09

a lot of topics. That's not a complaint.

Zack Jackson 29:15

No. And you know why we do that is because the United Church of Christ is a congregational denomination, which means that the national setting has no power to enforce anything on local churches. So when we get together every other year for General Synod and we make these grand statements of, of witness and whatnot, there's no actual accountability that has to come with that. We can just say these things and then send it to a committee to make a study on it and send out materials to churches. And so unlike other denominations, where when they say something, they actually have to do something about it, we can just say a lot of things. So that's kind of nice, but we did in 2007 have For a resolution on the sea, the resolution was called legalization of physician aid in dying. And as a result of that, they, they voted in to affirm this, which sent it to a committee to do research on the topic and to create a six week study guide for small groups and churches. It was designed to be used during Lent, which is the time in which traditionally, we imagine ourselves in the tomb with Christ. And looking forward to resurrection. And so it's very theologically focused. I will put a link in, in in the show notes. But, you know, one of the things that it really focuses on is that Christians should not be afraid of death, death, and resurrection is kind of our thing. Like, it's, it's an important part of the Christian tradition and story. And so if we believe that death is not a final thing, but a transition into something else, then how one's life ends, his lesson is not all that important. And so whether that person dies by natural causes or dies, in physician assisted ways, the it is still a transition into into what is next. And we believe that people are more than just their physical bodies. And so keeping a physical body alive is not inherently more virtuous than allowing a physical body to die. And so we came down on the side of supporting, but also in an informed way.

Rachael Jackson 31:58

Zach, just to get out of like a clarifying question, maybe, because I think what a lot of what we've been talking about is, you know, the policies and statements that are for this kind of, you know, choice in deliberating like how someone wants to die, but just in case, there's any confusion for people who didn't like grow up in, in a community where there was a lot of opposition to this. I just wanted to, like, put out there some of the ways that people have been thinking about, like, aid and dying, and, and I personally didn't grow up with a ton of conversation around this. So I'll just say, like, from, from what I understand, like some of the verses, I guess, that were, that could be used to, like, deny someone the ability to have, like their own, like authority in determining when they could die if they were terminally ill, or versus, like one in or several, I guess, in the New Testament, but I'll just read one, which is in First Corinthians 316 through 17. And it says, Do you not know that you are God's temple and that God's Spirit dwells in you, if anyone destroys God's temple, God will destroy him, for God's temple is holy, and you are that temple. And so it's like, versus like that, that I have these vague memories of people sort of using that as like, the theological argument of like, Well, someone shouldn't have should, someone shouldn't be able to make the decision to die before their time. Because, you know, like, the idea that your body is not your own, and that you just have to, like live until, like, God decides that it's not your time anymore. And so that's, that's, that's my memory of like that how that discussion went, but I like it. What else is there Zack? I feel like you probably have more like experiences and memories of how people have maybe argued this does that sound pretty? Pretty right to you? It does.

Zack Jackson 34:27

I was taught as a kid that taking any human life is a sin. And so taking your own human life is a sin. And because you took the life and then died with that sin, having not the opportunity to repent from it, then anyone who took their own life whether in this setting or in you know any other way would end up in hell was what I was taught in no uncertain terms. Yeah, which I think I've mentioned in a previous episode before, that my mom's explanation to me was that anyone who takes their own life, their brain typically has some issues going on. And God would see that in the same way that God would see the brain of someone with down syndrome who doesn't have the mental capacity to understand the ancient Creed's or, like, something like that. And it's also, as I reflect back now, I think about how those same people who would tell me that taking a life is a sin. Also found ways of getting around it when it was the death penalty or war. They found ways of theologically explaining those things, but not typically suicide, whether physician assisted or otherwise, or abortion, those were the two that were like, there's no way around that. But war and death penalty, they often found theological ways around it. And that's usually what we do, isn't it? when we, when our worldview supports something, we find a way of making our theology support it.

Ian Binns 36:15

So we cherry pick? Yeah, this this part supports my my conclusion. So I'm going to love this part, even if many other parts don't support it, I'll ignore this. Yeah, and I think that

Rachael Jackson 36:30

what you just said back to like that, that also resonates are I remember, some of my, like early conversations, saying that exact thing like about people going to hell when they make that decision. And I think what is what was always absent from those conversations, though, those like theological interpretations, it seemed like there was a conflation of all the circumstances in which someone might choose to, like, take their life. And obviously, it's like a super sensitive subject and really complicated, but I think that, like, a lot of what we've been talking about here, right now is, you know, the idea that, like, we're talking about a reduction in suffering, or like the attempt to reduce suffering and, like, focus on like, quality of life, rather than quantity of life. Which, you know, still still tricky, still controversial, but that that's really, I think, the core of what people are are thinking about when they like support something like the Death with Dignity act, and it's, it's, I think it does in in a lot of cases come down to are you are you emphasizing quality, or quantity? And it's not always easy to like separate those things out but that's where I see the difference and maybe like the the core of some of the disagreements about like whether this is a good thing.

Zack Jackson 38:11

I think I would be really interested in hearing different points of view based on profession. Yeah. Cuz I think a couple of years ago, this whole topic would have made me very uncomfortable. But I'm death is just such a part of my life. As a pastor of a primarily older congregation. All all day, all week all year, I'm, I'm with the dead and the dying and it has lost its staying. death itself is no longer something that really terrifies me. It's it's become this kind of more beautiful part of being alive. This transition that it's hard to explain, because then it makes you sound callous, and a little dead inside. But I think it's one of the most beautiful experiences when I can be present with someone at the end of their life. It is this holy and sacred thin space when somebody is breathing their last breaths. So I'm not afraid of it anymore. You know? Plus, I live with a pastor who used to be a hospice chaplain. So like, we talk about death around the dining room table.

Rachael Jackson 39:34

Just your everyday dinner conversation.

Zack Jackson 39:38

Yeah, so I almost kind of like the idea of getting to choose when you go because then you're not, then you're not worrying about the process of dying. Adam. Oh,

Adam Pryor 39:51

Zach, what you mean like death became a part of life. You said that, which is only interesting to me because Rachel said it too. Is that? Yeah, exactly. That's exactly what I'm after.

Zack Jackson 40:07

All right, so. So I did a CPE, which is clinical pastoral education at Thomas Jefferson University Hospital in Philadelphia. And my very first day, I was training with one of the chaplains, I walked into a room, because she had given called in, and the woman had died. Just maybe 15 minutes before we got there. And I didn't know that. And I'm standing in the room, and somebody mentions that she's dead. And I looked over at this person laying there that could have just been sleeping. But then suddenly, I was aware that this person had died. And I felt so weird. And I felt so creepy because this person wasn't prepared and dressed up and you know, the whole, like, Oh, they look just like they're, they look so good. The way you do it a viewing. This is a person that was still hooked up to machines and looked pretty bad, and was dead. And it was horrifying. And there's a certain smell that comes with death. And I thought about that for days and weeks. And then I just kept going and doing it. And as a chaplain being called when people were at the end, and sitting down with people, and you kind of I don't know, you do a scary thing a couple of times, and you get through it, and it's not as scary. And then once you're less afraid, you start to notice the more holy aspects of it. You know, for example, when a person is dying, and they know that they're dying, and they have disavowed themselves have the this mythology that they will live forever, and they know that the end is near, do you know the kinds of conversations you can have with a person in that state? They are the most honest conversations that that person has ever had in their life. And to be able to just speak openly about like, what do you think it's gonna be like, later on? Today? Maybe even? What do you think? those spaces, those conversations, it's almost like talking with an astronaut before they they go off into the great expanse, you know, you're, you're about to go see something that I'm not gonna see for a long time. And I want to talk with you about how you're feeling about it. And so I do this, and I've done this for years. And yeah, this is why most pastors were telling me they prefer funerals to weddings. There's less drama, and there's way more honesty, and it's a much more sacred and holy place that, that thin space at the end of life.

Adam Pryor 42:51

So I mean, I'm kind of sad, Rachel is not here, because I think it's like, probably the like place where like, we were gonna line up more than she would want to give credit for. I mean, I'll still still poke at her. But especially cuz she's not here to defend herself. But I'm an academic, that's what we do. So what I'm thinking about Zach is like, I think this language that both you and Rachel use, I think it comes from a very, like, pastoral. I mean, that in the broad sense, right, a sense of care place, to delimit to expose a place of scientific overreach, I don't think is like what we would describe it as doing, but I think it's implicitly what, what's happening, right? Which is, in a sciency way, right? Life is not dead. How do you define life? It's the persistence of not dying. Right? And if life is taken as that it's terrifying to die. But that's a very, I think, particularly in the 20th 21st century, right? Like, that's a very scientific way of getting at this right. It's this sense of saying, science has described for me, the ways in which something is living. Right, called biology. And, and what I think like, what I think is interesting, is that the pastoral approach that I think both you and Rachel want to take, wants to put the brakes on that for a second and say, hold up. what we think of as living might not line up directly with a definition Have the mechanics of a body or thing, trying to continually self perpetuate itself. And, on the one hand those sound like, like, Okay, so that's how religion is going to do this. And on the other hand, there are these sciency things that you can do, which are great. And, you know, sometimes great, and sometimes we should use them. And sometimes we shouldn't, but, but I think what, what I would push on is that, I think how we decide when to use and when not to use those medical and scientific interventions, lines up with, not how we think about death. But how we've defined life. Like, by bringing death into a part of life, right, you've reframed the conversation in a way that you can't, in the scientific context, because for somebody to be dead, be fundamentally not to be alive. Right, whereas that binary gets broken down. If you make death part of life.

Zack Jackson 46:27

at its best, one of the things that religion is supposed to do is to suppress the ego. And a person. Religion is a way of connecting a person to something larger than themselves. And one of the ways that my personal religion my faith does that is through knowing how interconnected that I am, that I mean, in my faith, I'll call that the Holy Spirit. I will also from my, you know, scientifically, I'll talk talk about the the atoms and molecules in my body, that are constantly being introduced and sent back out and you know, re forming and fighting back against entropy in order to create this thing. But that, you know, stars exploded A long time ago. And those those star pieces made this, and they made countless other living creatures before me, and they will make so many more after me. And so the me I see as a we, I don't, I'm not so worried about the death of my ego, because my religion has helped me to kill most of it anyway. And so, you know, people talk about having leaving a legacy, how will people remember me? How will I be remembered, they build these pyramids in the desert, because they want to be remembered, the ego has to live on well afterwards, which completely misses the entire point of the interconnectedness of the universe, and just the miracle of life, you know, Carl Sagan said that we are a way for the universe to know itself. And I love that I think that's has such, so spiritually profound. Those, those atoms that were created in those supernova are now able to know themselves because of this brief instance that we call Zack Jackson. And I love that, and I, so I think of death. And this is why I said at the beginning, that when I die, I want to be composted. Because I, when you cremate someone, you'll lose a lot of a lot of that organic material to the combustion. When you bury someone in a, like, traditionally, you know, you don't give back and I want 100% of, of what I am to go back, because I want it to live on as it lived on before me.

Rachael Jackson 49:13

And when you're pressed into a gemstone, similarly, you also live on

Zack Jackson 49:19

100%. I mean,

Adam Pryor 49:24

I think I mean, there's no segue from pressing people's bodies into gemstones that I can that I can make. I so yeah. I I'm also thinking about the question that Rachel asked Dan. And like, where that falls into this and like how I would think about it, and to not give the like snarky I need more information answer. Like Well, I I'm gonna stick with my snarky, like, I need more information, but not in the like, not in the sense of like, Okay. In an almost snarky or sense, don't worry, I'm gonna go, I'm gonna go deeper, which is to say like, even if you gave me the information, okay, I don't know if I could answer the question one for anyone but myself. And two. For me this sort of like I, I'm very sympathetic to this idea that that like death is part of life right to overcome that dichotomy, right and that it has this, that making that movement and using religious traditions to make that movement de centers as in really, really important ways. So, I am 100%, on board there, it still leaves me with a big, long polling question, right, which is almost I think, harder, which is then to say, like, we will, but then how do you define that living thing? Like, how do you find that living thing that can be subject to death? And now, it's not just living by being a proxy of not being dead? Like, that's the question that that for me, comes immediately after the very pastoral movement that I heard you and Rachel making. And I mean, I think it's exciting because I don't think there are great answers to it. But also, I would take a stab at answering it, which is, I think what makes Rachel's predicament so difficult to deal with. So, I, I would play a language game, unsurprisingly. Right. Which is to say that we when we when we say something is living, or what it means to live, right, we can meet it in two senses, grammatically, and in transitive and a transitive sense. So we can mean it as something is alive. Right? as a state of situation, or we can mean it as the experience of living. Right? So that it's this this lived experience that one has not a state of being something, right. So it has these two senses when we use it. And for me, I think it's getting in to and being cognizant and about that sense of the lived experience, that's really important. Can I identify a set of experiences that living stuff house, that's essential to how I would think about whether or not I'm not actually ending my life is that 29 year old with the brain tumor who now has pneumonia. But as the 29 year old with a brain tumor, who's now got pneumonia, was I already dead? Because I had ceased to do the things by which I would constitute having living experience. So I'm not actually dying. And doing that no one's assisting me in dying, I was already dead. Even everybody that looks around me says, aha, you're alive because you have a heartbeat, or brain function, or this or that other thing. I mean, don't get me wrong, I know this goes down like a, an ethical, good. gray area might not be the right description, ethical terror, then that that can result. But I do think it's really I think it's really important to shapes the way that I think about life in what it means to live in really, really critical ways. I'm so sorry. Now I'm monologuing. Right? But like my, my bit here would be to say like, my cheeky answer of like, I need more information. Is that like, when Rachel puts that scenario forward? What I think about is me at 29. And at 29. I've got a three year old kid. And there are a vast number of things that I desire to have in relationship to the people who are in my life at 29 that says, Hell no, go treat that pneumonia. But I can also imagine a 29 year old for whom those desires for relationships which would be really critical to how I would define life are really gone. And then the pneumonia is, is the friend that makes a death that is already realized for that person available to everyone else to mourn?

Rachael Jackson 55:11

Yeah, I see a lot of what you're saying, Adam, as relevant to, like, the way that we kind of started and talking about, like, what, what are these different kinds of deaths and that we have, understandably, like an over emphasis maybe on like, the physical death. Because, you know, that's like, our physical bodies are a threat everyone, like sees and experiences immediately and, you know, I guess it's like, easier to make policies that affect those physical.

Adam Pryor 55:53

Like, I can measure the thing that I just,

Rachael Jackson 55:55

exactly. And that's what it like, the the scientific piece is, um, you know, it's far from simple, but it is simpler. And some cases, when you're dealing with, like, the physical stuff, but that there is, you know, we can talk about social death, or whatever other kind of death, but I think like, what you were just elaborating is, like, what I would call a social death of being totally disconnected, having like, no support system and no drive or capacity to be connected to a community or to a support system. And, you know, I get that that can like sound a little dramatic, I guess, to say, like, you're socially dead if you don't have those things. But, I mean, there's no, there's no denying that that makes an impact on people's lives, and all sorts of measurable ways that like social science has been measuring for, you know, many, many decades. And so that there's something about that feels really intuitive to me, even though, yeah, like you said, there's also like all kinds of other ethical conundrums that come up. But also,

Adam Pryor 57:13

let me just say, I mean, I'm cheating. I did write part of my dissertation on like, phenomenologies of life and death. So like, it's not like I just like came out with this quickly, like, I mean, I've been thinking about it for a decade. So yeah, I just, I feel like I should I want to do research,

Ian Binns 57:39

that I should all do research. I don't really wish you'd come up with these answers totally on the fly. So I'm gonna have to just dismiss everything you said?

Zack Jackson 57:49

Well, I learned all of my lessons about death from the school of hard knocks out on the front lines.

Adam Pryor 57:57

I mean, I will say too, though, I, I do think about it in personal ways, right? Like by my mother has pretty severe dementia. Right? Which has an interesting place within how people talk about death with dignity, right? It doesn't fit the legalistic framework that's been set up for like the Death with Dignity movement. And I think that's, its mean, a sound super cold. And I don't mean it that way. But it's like, in some ways, sort of interesting to see the ways in which working with a person who loses mental faculties illustrates the ways in which one's life is not one's own.

Ian Binns 58:47

Well, what is the difference? I feel like I know the answer to this, but the difference between death with dignity and a living will

Zack Jackson 58:55

a living well just says what you want to happen to you.

Ian Binns 59:00

Right? So you know, if you're,

Zack Jackson 59:03

if you're in a state where that sort of thing is legal, then you could put that in your living well,

Ian Binns 59:09

right. Well, you make that but I mean, if you're in a situation like that's where you write down, you don't want any extraordinary measures are taken that kind of stuff.

Zack Jackson 59:18

Right? Which listener if you don't have a living will, it's not hard to do and you should, you should definitely do it. My wife and I both have it you never know. You never know and it is always better for the people who are trying to take care of you if they know your wishes ahead of time and then every hospital

Adam Pryor 59:35

chaplain will thank you Yep.

Ian Binns 59:38

In my having written down Yes, every hospital chaplain will take you haven't officially written down and a living will takes away all those questions.

Zack Jackson 59:48

Write and right let it let everyone know what you want for your funeral for my mom has been making a playlist for her funeral for years, which includes Zombie by the cranberries which I told her is in bad taste

Adam Pryor 1:00:07

that decision

Zack Jackson 1:00:14

Yes, she at one point wanted time if your life by green days she was going through something in the 90s until I told her that the name of the song is actually good riddance. And then time of your life, it's a tongue in cheek song. Despite the fact that every single graduating class in the late 90s, early 2000s used it in their graduation. It is not what you think when you talk

Ian Binns 1:00:39

about like, for some reason, maybe think about this. But Did you all hear the story of the Irish man who died in 2019? And he set it up so that when his casket was being lowered into the grave, he had recorded himself? Oh, he was a prankster. As it's going down, all sudden, you hear his voice being like, hey,

Adam Pryor 1:01:06

let me out. Let me Oh, stuff like that. That they put out, right? Yeah. The soul Bell like, you know, because sometimes they got it wrong. You weren't really bad, or people were afraid that they got it wrong, or that you weren't really dead. So you could ring a bell and they would open the casket real quick. And you know, usually that was gross.

Rachael Jackson 1:01:25

Yeah, no, that is terrifying. Which is why if you get pressed into a gemstone and then have the rest of your body buried as Dustin of death, you can, you don't have to worry about that.

Zack Jackson 1:01:39

This is the reason why Thomas the campus is not a saint, despite the fact that he wrote the second best selling Christian book of all time, the imitation of Christ, when they zoomed his body, they found claw marks on the top of the coffin because he had been buried alive and they said a real saint would have just accepted his debt instead of fighting it. And so they never canonized him, which is Bs, which is why I think I call him a saint when I when I think about my bookie and that's all that matters, right? Oh, boy.

Ian Binns 1:02:13

So yes, dear listener, if we don't have in our notes, look it up Irishman pranks his family funeral, it was hilarious to watch. But the thing is that everyone expected it. Yeah. Okay, so first read it. They all tell everyone to do stuff like that. If you don't know, I don't think. I don't think he told them that he was gonna do that. I think maybe if you knew, but at least they knew he was a prankster. Right? And tell the funeral director telling jokes. And oh my gosh, it's so funny. To see all those people just chuckling. So, yeah, I think I'm gonna put some like that. So everyone

Zack Jackson 1:02:58

wants that everyone wants people to laugh at their funeral. Everyone I've ever talked to about this, they always go, I don't want people to cry and be sad at my service. I want people to be happy and tell stories and laugh. And every single person said this, I always tell them, do you think there's anyone out there who wants their loved ones to cry? No. But we're going to, because we're going to miss you. You're not going to be there. So you really don't get a say in this. And I'm going to cry at your funeral. And there's nothing you can do to stop me. And if you want to haunt me, go ahead. I'd actually kind of like that, I think, at least for a little while. Don't do anything weird and creepy. So like, my grandma told me, she doesn't want to serve us because she doesn't want people crying. And I said, I don't care, grandma. And she looked at me and she was like, might you wait, no, this is what I want. And I said, I don't care, because you're not going to be here. And these services are for the living and not for the dead. And there have been too many times people didn't want to burden someone else by you know, they don't want them to be sad, and then they don't get closure. So I'm all for respecting people's wills and wishes and all of that. But I am not above throwing a gorilla funeral service. When I need to

Ian Binns 1:04:13

fly I want to be I like in the various cultures around the world that treat it more as a celebration of life. Where they still have the moment and the funeral or somewhere where it is sad and things like that. But that it is a I remember, when I was a Peace Corps volunteer in Jamaica, that was what they were. Someone was explaining to me it's it's a celebration of that person's life.

Zack Jackson 1:04:32

I learned recently that Church, The Orthodox Church has an annual Feast on the day of a person's death for the first couple of years. So you get your family back together. You have a big meal and you share stories of that person on the anniversary of their death. And I think that's

Rachael Jackson 1:04:48

spectacular here. The dead one that's a great opportunity to hot people.

Adam Pryor 1:04:54

Absolutely. So efficient and catterall. There. That's what everybody longs for.

Zack Jackson 1:05:03

Just get them all in one place takes a lot of energy to haunt Adam.

Ian Binns 1:05:08

Yeah, I will have to say, Zack that I do feel like this conversation was probably a little bit more uplifting than the conversation about middle age,

Zack Jackson 1:05:21

which is hilarious, right? And a part of that, I think is because I wasn't there. I

Ian Binns 1:05:25

feel I feel happier. After this one than I did the last one,

Zack Jackson 1:05:30

the middle aged conversation was about the fear of death. And this one is about the acceptance of accepted it. It's great.

Kendra Holt-Moore 1:05:41

Yeah, I was gonna, I was gonna end with a quote that was gonna bring us back down. But I guess I'll just leave that off. Because I feel like we're in a good place. Oh, God, go

Ian Binns 1:05:49

ahead. Go ahead. Bring it No, I

Kendra Holt-Moore 1:05:50

don't know that it fits. It also takes us back to like terror management theory, which we've kind of not really been talking about. So this is good.

Zack Jackson 1:06:00

Okay, well, we can end our series with an announcement then, that this is the last episode in this mini series, which will bring us to, I think just about our two year anniversary. And so in celebration of that, and also because we have a whole bunch of professors that are going to be doing a lot of transitioning in this period, and a rabbi who will be entering into high holy days, and me who's just doing stuff. We're gonna we're gonna put up some of our favorite episodes from the first two years. And so if you missed them, or if you just want to listen to him again, because I've been listening to some of the older episodes, and there's some they're made of Kendra in there. And then after that, when we're gonna What's that? Yeah, they're made Oh, cuz they're gem gems. Ah, that was a call back I gotcha. Very well played. So when we come back from that, we've got a whole slate of new interviews and a new format for the show that will focus around storytelling, and a variety of new segments, which we're excited to bring you, which may or may not include books we've read or demons that we've loved or dead Christians. We want to tell fun stories about

Rachael Jackson 1:07:29

and listener questions gonna leave you

Zack Jackson 1:07:31

with that and listener questions. Oh, yeah, that's the important one. So we've got a lot in store for year three, and we're excited to bring it to you. gonna end it with that.