Introduction Chapter 1: In Praise of Maria: a memoir

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Thus, two distinct paths lie open for journeying to the spiritual. On the first path, emphasis is placed upon a spiritual discipline that aims to purify the individual ego of self-centered desires. The journey is mainly a withdrawal from those distractions that would hold the individual captive to desires that enslave. The most fundamental drives of the body for food, drink and sex, along with the means to acquire them, can so dominate a life that human desire is shut down at a primitive level.

The spiritual seeker discovers that there are more subtle attachments than to bodily pleasures; these desires can form a stronger chain of bondage. Attachment to one’s knowledge, to one’s reputation, or to performing good works is a worse danger because the objects of attachment seem to be spiritual. The saying that “the corruption of the best is the worst,” was a mainstay of medieval piety. This first path attempts to take a direct route to the spiritual. It is intent on one goal which is never lost sight of, namely, release from the “ego” and contemplation of what is ultimately important. Even people who are skeptical of this journey as a lifetime project may recognize the value of many of the practices in it. A child or an adolescent who has not learned any “self-control” is headed for a life in disarray.

The second path to the spiritual does not reject the first but sees it as incomplete, and as making a dangerous jump from the individual to the final good. Along this second path of personal development, soul and body must slowly work through their tensions on the way to the spiritual. Instead of withdrawal from “the world,” there is emphasis upon the joint development of person and community. The experience of brotherhood or sisterhood provides the main disciplining of the affections. A greater community is sought which can only emerge out of a struggle for justice. Thus, the spiritual is sought in roundabout fashion with excursions along side paths and immersion in the delights and the sufferings of this world.

The danger in this second way is that the goal can simply disappear from the map. One is so intent on doing good, on improving organizations, and producing new ideas, that the spiritual purpose is submerged. As one’s energy flags and death approaches, the activist for good causes may wonder if that’s all there is. Nonetheless, if a life is truly devoted to love and justice, then religions would call that a spiritual journey, even if God, heaven and salvation are not invoked.

Each of the world’s great religions incorporates both paths, emphasizing one or the other in particular contexts. The mystical strand in each religion comes closest to uniting the two paths. Mysticism is intent on transcending all the divisions which wrack individuals and societies. Mysticism includes a withdrawal from ordinary politics but it is not apolitical. A disciplined life devoted to mystical union can have political repercussions.

Mysticism has dangers on either side. Its stark quest for “non-duality,” or being “oned with God,” can end in the despair of a dark night. Its refusal to play politics can go askew into violence. The mystic needs a community to remind him or her of ordinary concerns that no human can entirely neglect. The mystic needs patience of soul. Instead of grasping for the end, one must quietly wait for the end.

Mysticism suggests that the final state of the humans is an overcoming of the dichotomy of subject and object. Mysticism can misleadingly be called “atheistic” in that it denies a theism that pictures God and humans as separate beings. A god who is looked upon would not be god, a point that Meister Eckhart tried in vain to convey to his prosecutors.cclxvi

The alternative to the dichotomy of subject and object need not be either an undifferentiated unity or a void. The richest human experience is an interpersonal and communal unity in which the opposition of personal differences nearly disappears. A subject/subject relation is not the opposition of two things but a unity that preserves enriching differences. If love is our ultimate intimation of reality, then beyond heaven and hell is a unity that has been enriched by what we experience as personal love. Each of the religions provides a glimpse but only a glimpse of that possibility




i Chapter Three

. Plato, Phaedo, 64.



ii. Baruch Spinoza, Ethics (London: Dent, 1986), IV, 67.

iii. Martin Heidegger, Being and Time, (Albany: State University of New York Press, 1996), 228.

iv. Heidegger, Being and Time, 236-46.

v. Sigmund Freud, Beyond the Pleasure Principle (New York: W.W. Norton, 1920).

vi. The HBO film “9/11,” first shown on May 26, 2002.

vii. Elisabeth Kübler-Ross, On Death and Dying (New York: Macmillan, 1969).

viii. Aries’ book on the history of childhood is Centuries of Childhood (New York: Vintage Books, 1972).

ix. Philippe Aries, Western Attitudes to Death (Baltimore: Johns Hopkins University Press, 1974).

x. The program was broadcast on Sept. 21, 1994.

xi. Kübler-Ross, On Death and Dying, Preface.

xii. Sherwin Nuland, How We Die, (New York: Knopf, 1994), Acknowledgments.

xiii. Erasmus, as quoted in Philippe Aries, The Hour of Our Death (New York: Oxford University Press, 298), 346.


xiv. Sogyal Rinpoche, The
Tibetan Book of Living and Dying (San Francisco: Harper, 1992).

xv. Philippe Aries, The Hour of Our Death (New York: Vintage Books, 1982), 536-38.

xvi. James Quackenbush and Lawrence Glickman, “Helping Adjust to the Death of a Pet,” Health and Social Work, 9(1984), 42-48.

xvii. On this question, see Daniel Schaefer, How Do We Tell the Children (New York: New Market Press, 1988).

xviii. Jeffrey Moran, Teaching Sex (Cambridge: Harvard University Press, 2000).

xix. William James, Varieties of Religious Experience (New York: New American Library, 1958.

xx Chapter Four

. Elisabeth Kübler-Ross, On Life after Death (New York: Celestial Arts, 1991), 25.



xxi. Elisabeth Kübler-Ross, Questions and Answers on Death and Dying (New York: Collier Books, 1974), 3.

xxii. Elisabeth Kübler-Ross, On Death and Dying (New York: Macmillan, 1969), Preface.

xxiii. For example, in Lorrie Moore, Birds of America (New York: Picador, 1999), a character who is mourning the death of her cat refers to going through the stages of anger, denial, rage, Hagen-Dass. Perhaps the most spectacular use of Kübler-Ross’ five stages is the structure of the movie All That Jazz.


xxiv. I refer here to the collections On Life after Death and Death is of Vital Importance (Barrytown, NY: Station Hill Press, 1995) and her memoir The Wheel of Life (New York: Bantam Press,1997).

xxv. For example, Dr. Samuel Klagsbrun, a psychiatrist well known for his work with the dying, said: “She is actively destroying the work she has done, which I think will long live after her attempts to destroy it....She’s killing her own work by denying death.” Quoted in Jonathan Rosen, “Rewriting the End: Elisabeth Kübler-Ross,” New York Times Magazine, Jan. 22, 1995, 24.

xxvi. Kübler-Ross, On Death and Dying, Preface.

xxvii. Kübler-Ross, Questions and Answers on Death and Dying, 25-6.

xxviii. Kübler-Ross, Questions and Answers on Death and Dying, 26.

xxix. Jean Piaget, Illusions and Insights of Philosophy (New York: New American Library, 1971).

xxx. James Hillman, The Dream and the Underworld (New York: Harper and Row, 1979).

xxxi. Gail Sheehy, Pathfinders (New York: Morrow, 1981), 9.

xxxii. Kübler-Ross, The Wheel of Life, 280.

xxxiii. Sigmund Freud, Beyond the Pleasure Principle (New York: Norton, 1920).


xxxiv. Erik Erikson, Insight and Responsibility (New York: Norton, 1964), 133.

xxxv. Robert Jay Lifton, The Broken Connection: On Death and the Continuity of Life (New York: Basic Books, 1983).

xxxvi. David Kuhl, What Dying People Want: Practical Wisdom for the End of Life (New York: Public Affairs, 2002). In one of his exchanges with the dying, the author asks the patient if he is afraid of dying. “No,” the patient said, “It’s different from anything I have experienced before. I have a calmness within me, and a quiet confidence that my life on earth is complete.” (253)

xxxvii. Gail Sheehy, Passages (New York: Dutton, 1976), 252.

xxxviii. Kübler-Ross, Questions and Answers on Death and Dying, 36.

xxxix20. Joan Acocella, “The English Wars,” New Yorker, May 14, 2012, 115-20, which reviews Henry Hitchings, The Language Wars: A History of Proper English (New York: Farrar, Straus &Giroux, 2012).

xl. Kübler-Ross, On Death and Dying, 40.

xli. Kübler-Ross, On Death and Dying., 39.

xlii. Kübler-Ross, On Death and Dying., 49.

xliii. Kübler-Ross, Questions and Answers on Death and Dying, 36.


xliv. The Dhammapada, ed. Gil Fronsdal (New York: Schambhala, 2006), ch. 17; Thich Nhat Hanh, Anger: Wisdom for Cooling the Flames (New York: Riverhead, 2002).

xlv.Thomas Keating, in Spiritual Silence, ed. Susan Walker (New York: Paulist Press, 1987), 285.

xlvi. Kübler-Ross, Questions and Answers on Death and Dying, 24.

xlvii. Kübler-Ross, On Death and Dying, 86.

xlviii. Kübler-Ross, On Death and Dying, 112.

xlix. Kübler-Ross, On Death and Dying, 120.

l. William James, The Varieties of Religious Experience (New American Library, 1958), 49.

li. William May, Testing the Medical Covenant (Grand Rapids: Eerdmans, 1996), 72-73, has a criticism that is almost the opposite of mine. He says that Kübler-Ross “overlooked this element of distancing that occurs in all authentic relationships.” Instead, she “wrongly urges a kind of intimacy between the healer and the dying, a mystical merging of the two, that does not fully honor the complicated transparency/opaqueness of all human encounters, from the most intimate to the most crisis-laden.” Perhaps she is vulnerable to that criticism in general but it is hardly a description of what she advocates at the time of the actual dying.

lii. Dylan Thomas, The Collected Poems of Dylan Thomas (New York: New Directions, 1957), 128.


liii. Kübler-Ross, On Death and Dying, 120;

liv. Kübler-Ross, On Life after Death, 30, 36, 37.

lv. Kübler-Ross, On Life after Death, 30.

lvi. Kübler-Ross, On Life after Death., 138.

lvii. Kübler-Ross, On Life after Death, 139.

lviii. Thomas Aquinas, Summa Theologia, IIa, IIae, 40, 1, ad 3.

lix. Gabriel Marcel, Philosophy of Existence (New York: Citadel, 1944), 32.

lx. Simone Weil, “Human Personality,” in The Weil Reader (Mt. Kisco, NY: Moyer Bell, 1977), 315.

Chapter Five


lxi William May, The Physician’s Covenant (Philadelphia: Westminster Press, 1993), 16, accepts the language of active and passive euthanasia but then argues that “the moral justification in each case depends upon the motive and intent of the agent and the wishes of the patient rather than on the act defined as an omission or a commission.” I think James Rachels, “Active and Passive Euthanasia,” New England Journal of Medicine, 29(1975) is logically on stronger grounds in dismissing any significant difference between active and passive euthanasia. If motive and intent are crucial to May, he should not accept Rachels’ language in the first place.


lxii Oxford English Dictionary, 904.

lxiii “The Physician and the Dying Patient,” in James Rachels, The End of Life: Euthanasia and Morality (New York: Oxford University Press, 1986), 88.

lxiv Robert Burt, Death is that Man Taking Names (Berkeley: University of California Press, 2004), 181.

lxv Betty Rollin, Last Wish (New York: Simon and Shuster, 1985).

lxvi Anonymous, “It’s Over Debbie,” Journal of the American Medical Association 259(Jan. 8, 1988).

lxvii Timothy Quill, “A Case of Individualized Decision Making,” New England Journal of Medicine, 324(March 7, 1991), 691-94.

lxviii Herbert Hendin, Seduced by Death (New York: W.W. Norton, 1998), 26-7; Richard Fenigsen, “The Report of the Dutch Governmental Committee on Euthanasia,” Issues in Law and Medicine, 7(No. 3, 1991), 330-44.

lxix Joanna Groenewoud and others, “Clinical Problems with the Performance of Physician-Assisted Suicide,” New England Journal of Medicine, 342(No. 8: 2000), 551-56.

lxx American Journal of Public Health, cited in the New York Times, Jan. 14, 1993.

lxxi Carol Tauer, “Philosophical Debate and Public Policy on Physician-Assisted Suicide,” in Must We Suffer Our Way to Death, ed. Ronald Hamel and Edwin DeBose (Dallas: Southern Methodist University Press, 1996), 60.


lxxii President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, “Deciding to Forego Life-Sustaining Treatments: A Report on the Medical and Legal Issues in Treatment (Washington: U.S. Government Printing Office, 1983).

lxxiii Congregation for the Doctrine of the Faith, Declaration on Euthanasia (May, 1980).

lxxiv May, The Physician’s Covenant, 76.

lxxv Pope Pius XII, “The Prolongation of Life,” The Pope Speaks, 4(No. 4: Spring, 1958), 395-96.

lxxvi Peter Singer, Rethinking Life and Death (New York: St. Martin’s Press, 1994), 70

lxxvii Daniel Callahan, The Troubled Dream of Life (New York: Simon and Schuster, 1993), 81.


lxxviii Mildred Solomon and Others, “Decisions Near the End of Life: Professional Views of Life-Sustaining Treatment,” American Journal of Public Health 83(1993), 14-17.

lxxix Cathy Siebold, The Hospice Movement (New York: Twayne Publishers, 1992), 48.

lxxx Solomon and Others, “Decisions Near the End of Life: Professional Views of Life-Sustaining Treatment,” 33: “Eighty percent of physicians agreed that “all competent patients have the right to refuse life-support, even if that refusal may lead to death. However, the wishes of patients often go unrecognized.”

lxxxi New York Times, Oct. 18, 1994.


lxxxii Interview on the ABC Television program 20/20, Dec. 5, 1985.

lxxxiii Stephen Carter, The Culture of Disbelief (New York: Basic Books, 1993), 242-43.

lxxxiv Ronald Dworkin, “What the Court Really Said,” New York Review of Books, Aug. 8, 1996.

lxxxv Jonathan Glover, Causing Death and Saving Lives (New York: Viking, 1990), 166.

lxxxvi Burt, Death Is That Man Taking Names, 163, 167.

lxxxvii Washington v. Glucksberg, 1997, 117 S. Ct 2258; Vacco v. Quill, 1997, S. Court, 2258.

lxxxviii Dworkin, “What the Court Really Said.”

lxxxix Burt, Death Is That Man Taking Names, 116.

xc New York Times, June 27, 1997, A 18.

xci Thomas Lynch, The Undertaking: Life Studies from the Dismal Trade (New York: W. W. Norton, 1999), 170-71, asks the ironic question: “Why not a pearl-handled, silver-bulleted, hair-triggered, 22 caliber Smith & Wesson? Pressed under the right earlobe, the entrance wound is tiny, the severance of the spinal cord is immediate and humane, and the exit wound, if there is any, leaves no mess at all.”

xcii New York Times, Dec. 9, 1990.


xciii William May in Must We Suffer Our Way to Death, 105.

xciv Chapter Six

 Albert Camus, The Myth of Sisyphus (New York:Vintage Books, 1955), 3.

xcv The Surgeon General’s Call to Action to Prevent Suicide (Washington: U.S. Public Health Service, 1999), 3.

xcvi Oxford English Dictionary, 3145.

xcvii John Donne, Biathanatos

xcviii Anthony Flew thinks that the use of “commit” with suicide signals the act as negative; Daniel Maguire, Death by Choice (Garden City: Doubleday, 1984), 183.

xcix For historical studies, Alexander Murray, Suicide in the Middle Ages (New York: Oxford University Press, 1999); Georges Minois, A History of Suicide (Baltimore: Johns Hopkins University Press, 1998); for the medical side of suicide, Kay Redford Jamison, Night Falls Fast (New York: Knopf, 1999); for philosophical and psychological insight, James Hillman, Suicide and the Soul (New York: Harper, 1975).

c G.K. Chesterton, Orthodoxy (Garden City: Image Books, 1959), 73.


ci Augustine of Hippo, City of God (Hyde Park: New City Press, 2001).

cii Alfred Alvarez, The Savage God (New York: Random House, 1970), 52.

ciii M.T. Clancy, “Review of Alexander Murray, Suicide in the Middle Ages,” in Times Literary Supplement, April 2, 1999, 14.

civ Minois, A History of Suicide.

cv Jamison, Night Falls Fast, 18.

cvi Jamison, Night Falls Fast., 17.

cviiJamison, Night Falls Fast., 100.

cviii Maurice Lamm, The Jewish Way in Death and Mourning (New York: Jonathan David, 1969), 217.

cix Hillman, Suicide and the Soul, 30.

cx Margaret Pabst Battin, Ethical Issues in Suicide (Englewood Cliffs: Prentice Hall, 1982), 55.

cxi Battin, Ethical Issues in Suicide, 63

cxii Hillman, Suicide and the Soul, 60.

cxiii Alexander Murray, Suicide in the Middle Ages.

cxiv Emile Durkheim, Suicide (New York: Free Press, 1951(1897)).


cxvHillman, Suicide and the Soul, 63.

cxvi Hillman, Suicide and the Soul, 70.

cxvii Karl Menninger, Man Against Himself (New York: Harcourt, Brace, 1938); Edwin Shneidman, Definitions of Suicide (New York: John Wiley, 1985), 21.

cxviii R. A. Moody, Life after Life (New York: Bantam, 1975), Afterword.

cxix Hillman, Suicide and the Soul, 73.

cxx Robert Neale, The Art of Dying, (New York: Harper and Row, 1973), 63.

cxxi Neale, The Art of Dying, 68.

cxxii Elisabeth Kübler-Ross, On Life after Death (New York: Celestial Arts, 1991), 18.

cxxiii Carlos Gomez, Regulating Death: Euthanasia and the Case of the Netherlands (New York: Free Press, 1991); Johanna Groenewoud and others, “Clinical Problems with the Performance of Euthanasia and Physician-Assisted Suicide in the Netherlands,” New England Journal of Medicine, 342, No. 8(2000), 551-56.


cxxiv “Meddling with Oregon’s Law,” New York Times, (Oct. 30, 1999), Editorial page.

cxxv “Aborigines Fear Euthanasia May Be Legal Suicide,” The Australian, August 4, 1996.



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