2 What Is Demise?
David thought that of all things, he knew what death was. But as things turned out, David wondered whether he truly did know. In the span of just six months, David saw his mom diagnosed with a terminal illness but then promptly recover. In the same timeframe, David attended the memorial service of a friend killed in a car crash, where incredibly, the whole church, grieving family members included, sang and danced in joyful celebration of the Lord. And in the same period, another friend’s child drowned in icy waters, was declared dead at the scene, but came back to life in the ambulance on the way to the hospital. On top of all that, David’s wife told him of a dream she had of joining her deceased father in heaven, while imploring him to get things straight so that she’d see him there, too. David was realizing that he might have some work to do on a subject he’d rather ignore.
Definition
Demise may seem a strange thing to have to define. Isn’t death’s definition obvious? Yet take a close enough look at death, as I did in my book Facing Death, and you’ll realize that some definition can help. It’s not as clear or final as you may think, as the following discussion shows. But first consider the etymology of the word demise, drawn from a Latin word meaning to send away by way of a French word for to dismiss. One’s demise poignantly refers to a sending away and dismissal from the earth, as in, “You’ve done enough here, good soldier. On to your next assignment.” In English, the word demise initially referred to transferring real property and sovereignty upon death. And once again, that earlier usage seems apt. We come into the world with nothing and leave with nothing. Our demise involves transferring our property, leaving appropriately open what happens to us. In time, the English word demise came simply to mean one’s end.
Spectrum
The above introduction reminds us of what we all know but sometimes unfortunately set aside, which is that human demise holds both the utterly profound and the entirely mundane, and the full spectrum in between. On the one hand, nothing is quite as natural as death. Living things die. What are the seasons but renewed life, a brief flowering, a rich harvest, and slow or sudden return to the soil in death? Indeed, death is the natural aspect of any organic entity. Life, not death, is the profound thing. Life, not death, is the supernatural and inexplicable thing. We study life to describe its processes, but those processes are so incredibly complex, minute, and intricate, even at the single-cell level no less at the level of the whole organism, as to leave us astounded, in pure wonder. Death, by contrast, is the easily explicable thing because it involves the disintegration of the living thing that we can hardly understand. Death returns the material to things we believe we know, control, and understand. It’s life that we cannot fully know and instead holds us in its thrall. In bringing life gradually or swiftly to its end, demise moves things from the most profound of wonders to the most ordinary of material things, the literal dust of the earth.
Perspectives
Demise is thus many things, nearly encompassing all things. Don’t think you know demise simply by knowing one of its spectral dimensions. Instead, accustom yourself to choosing the right lens through which to see demise, at the right time and for the right purpose. You already intuitively know to do so. You wouldn’t respond to a newly grieving widow with a scientific evaluation of the spouse’s demise, at least not if you had a heart and wit about you. You would instead respond in shared loss, compassionately. If you were the widow’s pastor, you might respond reassuringly of the departed’s eternal destiny beyond. If you were the widow’s financial advisor, you’d have sound and practical financial advice. If you were the decedent’s estate attorney, you’d be reassuring the widow of control of the widow’s home and means of support. If you were the coroner investigating a suspicious death, you’d stick to your forensic science and likely not communicate with the widow at all. All these and other perspectives on death can inform us importantly of how to prepare for our passing. Consider the following glimpse of several perspectives on the nature of demise.
Science
Science has a surprisingly difficult time defining life. Nobel-winning Austrian physicist Erwin Schrodinger’s classic What Is Life? defined it by eating, drinking, breathing, or similar metabolic processes delaying decay. Life also implies a unit with limited duration, controlled by its own information. Maintaining a relatively constant form is another critical life attribute. To science, we are programmed metabolic containers. Does that help? Not much. For humans, life means much more than just that, including especially the capacity for intelligent self-reflection. For humans, a living body but a dead brain may be the same as death. And there you go: even to science, human life includes the potential for experience, personality, and identity. Some scientists give time a role in defining life and death, relying on the obvious that a living organism persists over time to its end in death. Yet other scientists question whether an organism today is really the same organism tomorrow, when natural processes replace the organism’s material, and development changes the organism’s character. You’re not really the same person today that you were a decade or two ago. Scientists even regard death as more of a process than an event. We may die socially at one moment, emotionally at another moment, mentally or cognitively at another, and physiologically or biologically at other moments. Don’t take death as a single, clearly defined event. Science suggests treating death more like a process.
Medicine
Medicine may have even more trouble, both theoretically and ethically, in defining the boundary between life and death than science has faced. Medicine, referring to the generally accepted tradition in the West, has modified its definition of death as its understanding and treatment capacities expanded. A modern definition of death defines it as the whole and irreversible cessation of brain and brain-stem function. You’ve likely heard the medical term brain dead. Medicine previously defined death as irreversible cessation of heart and lung function, until heart and lung machines and transplants came along. Hence the move to brain death. But disagreements now exist among what part of the brain must die to declare someone dead. Indeed, the standard for death appears to have moved toward irreversible loss of consciousness, not of brain activity. Brain death, too, isn’t necessarily observable. Two EEGs twenty-four hours apart showing zero electrical activity is the presumed standard, but many hospitals simply use blink, gag, cough, and shiver tests instead, without bothering over an EEG. Better to harvest organs that way. Indeed, inducing brain death to harvest organs may be a relatively common silent, if wholly unethical, practice. Be sensitive to these huge medical questions of what death is, when asking a close relative or friend to act as your medical advocate.
Consciousness
You’ve just seen how brain capacity and even consciousness can relate to the question of death. You’ve doubtless heard of unconscious individuals in persistent vegetative states. You may even have heard about or have been involved in a debate over whether to continue life support for an individual who is plainly alive but appears incapable of regaining consciousness. But don’t take the diagnosis of a persistent vegetative state as a clear marker within that very unclear debate. Studies of those diagnoses show error rates approaching fifty percent, little better than a coin flip. Axonal regrowth may well be possible, as demonstrated in other species. Individuals have regained consciousness out of vegetative states that had lasted as long as two decades. And then, medicine faces the question of just how vegetative a state must be to qualify a patient for removal of life support, in other words for certain death. Some medical professionals advocate that the bare ability to communicate is insufficient to overcome the presumption of death. Medicine, though, faces yet another uncertainty in the documentation of frozen states involving perfectly conscious individuals who have lost the capacity to respond. Like a nightmare, they can hear and remember people speaking about them as if unconscious, when they are not at all so. They just look and act dead but have, in some instances, regained their capacities to describe how terrifying it was to nearly face physician-induced death. Again, be sensitive to these questions of what death is, when designating and informing your patient advocate.
Culture
Death is clearly harder to define than we might wish. Death is at the same time more than an individual event and concern. Death is, in a way, the author and deeper guide of human culture. We cannot generally experience our own death and then thereafter contemplate it for our own benefit. Death instead lies beyond personal experience. Except in the many cases of near-death experiences, and fewer cases of through-death experiences, we must regard death through the demise of others rather than our own demise. Fundamentally, culture serves that purpose. Death generates art, music, literature, theater, film, photography, and even dance and other expressive forms, to serve our need to contemplate or countenance our sure demise. The torturous demise of the Son of God who rose again to life suffuses the Western artistic and literary canon and its forms. Culture shocks, guides, and consoles humanity with its depictions and treatment of death. Not just art but all communication is a form of declaring life while denying death. First Amendment freedoms ground themselves in the inherently life-giving aspect of expression. Don’t deny death its due when considering its meaning. Death’s own subduer is the author of life. Through death’s door we enter eternal life.
Law
Death is also a legal event, not just a personal, social, and biological event. You’ll do well to prepare for your own demise by treating it that way, as a legal event. A first question law addresses is physician-assisted death, assisted suicide, aid in dying, or by whatever other phrase one calls ending one’s own life through the actions of others. Law generally prohibits such actions or at a minimum tries to closely regulate and limit them to the terminally ill because of inevitable questions of competency, coercion, and informed consent. Assisted suicide also has an inevitable influence on how the healthy elderly and disabled think of their life and how we also think of them. Law, though, hesitates to command or authorize intervention when a competent adult seeks to end the adult’s own life, whether actively or through passive means such as the refusal of nutrition and hydration. Law generally strongly supports advanced medical directives that a patient makes for the patient’s own care when the patient is still competent. Law typically cedes to physicians the choice of whether to apply the heart-lung or brain-dead definition of death but, good thing, demands a legal declaration of death before permitting any organ harvesting. In another good thing, law prohibits the personal sale, in advance of one’s death or by one’s surviving relatives, of body parts. Law encourages that you arrange for the orderly disposition of your property, though. Another chapter addresses that wisdom.
History
Death also has a history that in some respects can inform one’s judgments on the subject. Humans have planned for their own demise, while venerating their dead, since the earliest known history, as long as tens of thousands of years before the ancient Egyptians built mammoth pyramids anticipating their death and commemorating their dead. Ancient Egyptians, Greeks, Hebrews, Babylonians, and others all not only venerated the dead but also made efforts to preserve and honor their spirits. Renaissance interest in anatomy and medicine didn’t diminish memorializing the dead but did spur greater efforts to delay or even reverse it. Resuscitations of the dead are now fairly common for up to twenty minutes after death and have extended for up to eighty minutes after death. We also have a long history of declaring living persons dead, only to have them revive. The ancient breath and heartbeat tests for death sometimes missed their mark. Today’s brain death tests, where the body still breathes and the heart still beats, haven’t at all eliminated the problem. Notorious instances of morgue revivals continue. Your happy fortune may not be resuscitation. But with due planning, it may be veneration and a transcendent spiritual body.
Philosophy
Death also has a philosophy that may inform your judgment on the subject of your own demise. Philosophy might, for instance, tell you not to worry about your lost years after your demise because you won’t be around to experience them. We experience the loss that comes from death only before it happens, when projecting and anticipating the loss. Project and anticipate less, and you will experience less. German philosopher Martin Heidegger, often distinct in thought and equally helpful, held nonetheless that our being arises out of our willingness to comprehend our own coming death. Death demands soul searching. Death, in the sense of limited years of life, also demands living for essentials rather than frivolities. Indeed oddly, death demands living for eternity, counting our each word as precious if not also as permanent and potentially our last. Death is thus immanent in life, present in our existence and consciousness, which arise out of our contemplation of no longer having life. You may scoff, but our lives would have no arc or trajectory if we lived eternally, without death to pass over into the other realm. Don’t necessarily try holding death at arm’s length. Contemplating death may enervate and inform your soul. We don’t truly live in the moment but instead live forward anticipating the moment we no longer live.
Religion
Death, though, draws its ultimate meaning only from religion. Religion is not simply a matter of faith traditions, although traditions play spectacularly significant parts in everything we do, from science to culture to art. Religion is instead, in its Latin etymological sense, that which binds together. Religion is the structure out of which we make meaning from the ultimate ideal or ultimate being beyond created being. Religion is the process through which we individually and collectively draw all experience together, into an understanding that matches its phenomenological reality. And religion has, from time immemorial, given its greatest attention to life, death, and the transcendent realm beyond death from which the creator gives all creation its material and meaning. That all may sound too abstract for a subject so concrete as death. Yet the Christian founder Cicely Saunders of the hospice movement showed the world that proper treatment of the dying involves not just compassionate pain relief within family and community but also support for our deeper religious truth seeking and meaning making. To properly navigate your own demise, you’ll need a good grasp on how the world binds together the reality of life, death, and life beyond death in the realm from which meaning and material issue.
Reflection
Has the above discussion at least given you pause in how you think about and define death? Can you see how death informs the full spectrum of issues from the most profound to the most practical and mundane? Do you also appreciate how you might need to shift your perspectives on death as you consider different aspects of your own demise? Does, for instance, science’s definition of death involving the cessation of metabolic processes really help you? Does it surprise you that medicine struggles to define death, while using different definitions in different circumstances? Do you value the timeless tradition of individuals and families preparing for death and societies venerating their dead? Do you equally value the timeless tradition of individuals and families honoring the spirits of the departed? Do you see how law’s treatment of death, including its invitation that you provide in advance for your final medical care and for the orderly disposition of your property, might be important to you? Do you have a clear grasp on the meaning and full possibilities of life, death, and life beyond death in the transcendent realm?
Key Points
Demise means to send away or dismiss, and to transfer property.
Death involves the full spectrum of issues from profound to practical.
Shifting your perspective on death is necessary for different issues.
Science treats death as the irreversible cessation of metabolic process.
Medicine treats death as the irreversible cessation of brain function.
Society may treat irreversibly lost capacity for consciousness as death.
Death constantly generates and informs the arts, literature, and culture.
Law cedes death’s definition to medicine but regulates other aspects.
Humans have historically venerated the dead and honored their spirits.
Philosophy treats death as generating life’s examination and being.
Religion makes meaning of death out of all experience of it.