Dying is a subject that many of us skirt around, finding it morbid and unsettling, especially when it concerns ourselves or close family and friends. Lydia Dugdale, Associate Professor of Medicine and director of the Center for Clinical Medical Ethics at Colombia University, is an internal medicine primary care doctor who believes that our approach and attitude to dying have changed to our detriment in the modern world.

Dugdale was inspired to write her book after coming across literature originating in the 15th century. The genre was known as ars moriendi (the art of dying) – a handbook for dying well, to be learned while still in good health, in an era when average human lifespans were relatively short. She concluded that we no longer anticipate and prepare well for our mortality for various reasons. She attributes this partly to advances in medical technology and facilities since the early 20th century, which enable us to distance ourselves from death. We are now also inclined to view medical interventions and hospitalisation as a tool to stave off death, even under the direst circumstances. She deems that sometimes such interventions aren’t beneficial and can add to the suffering of the dying.

Some of the topics she covers are finitude (accepting that there are limits to human life), community (staying connected to and supported by others throughout life and at the end of life), hospital vs home (understanding when hospitalisation and/or resuscitation may not be the best choice) and confronting fear of death and degeneration. Whilst the book is not intended to be religious, she also examines the role of spirituality and ritual in preparing for and navigating death.

The author draws on her own experiences, both negative and positive, with frail and terminally ill patients and shares other stories and trends that lend credence to her views. She encourages people to practice patience, hope, humility, faith, and less attachment to material things during their lives as a way of preparing themselves for the eventual end of life – and she asserts early in the book that “The art of dying well starts with the art of living well”!

A copy of “The Lost Art of Dying – Reviving Forgotten Wisdom” by L.S. Dugdale, MD is available in our Chartered client library for short-term loan.