The Good Funeral Guide

The Natural Death Handbook, Fifth Edition

A thoroughly updated and revised edition of the Natural Death Centre‘s celebrated handbook. Now presented alongside a new collection of essays on death, dying and funeral practices by doctors, historians, authors, poets, theologians and artists including Richard Barnett, David Jay Brown, Dr Sheila Cassidy, Charles Cowling, Bill Drummond, Stephen Grasso, Maggi Hambling, Graham Harvey, Gary Lachman, Nick Reynolds, and Dignity in Dying.

It’s out in May 2012!

“The current law exists to protect those who are sick, elderly, depressed, or disabled from feeling obliged to end their lives. It requires every case to be reviewed by the police and the DPP to determine whether a prosecution is appropriate. The present law protects those who have no voice against exploitation and coercion, acts as a powerful deterrent to would-be abusers and gives discretion to judges to temper justice with mercy in hard cases. The current law does not need changing.”

Dr Peter Saunders, Campaign Director of Care Not Killing

The Commission finds that there is a strong case for providing the choice of assisted dying for terminally ill people. Even with skilled end of life care,
the Commission finds that a comparatively small number of people who are terminally ill experience a degree of su+ering towards the end of their life,
which they consider can only be relieved either by the ending of their life, or by the knowledge that they can end their life at a time of their own choosing.

Download (free) the Commission on Assisted Dying report here. 

Since a stroke six years ago Tony Nicklinson’s life has been, in his own words, ’dull, miserable, demeaning, undignified and intolerable’. Tony can only move his head and his eyes. He has locked-in syndrome. 

And now he wants to die. 

In fact, he’s demanding the same right to end his life that any able-bodied person has. But because he is physically unable to kill himself, he’s issued proceedings in the High Court asking for a declaration that it is lawful for a doctor to terminate his life, with his consent and with him making the decision with full mental capacity.

Full story here. 

Hat-tip to Kingfisher 

Daily Mail article here.

I don’t know if you ever visit the Exit euthansia blog, or Exit’s website. Highly recommended. Exit is not Dignity in Dying, which used to be called Exit. Exit is the breakaway, ‘fiercely independent’ Scottish-based group which advocates euthanasia in the UK, has members worldwide, and has just published an updated edition of its guide to self-deliverance, Five Last Acts. I wish I had the money to buy a copy.

The Exit blog is unfailingly thought provoking and well informed. If it’s not on your blogroll, add it.

Yesterday’s post about the Euthanasia Coaster is fascinating. Euthanasia Coaster?

Euthanasia Coaster is a hypothetical euthanasia machine in the form of a roller coaster, engineered to humanely—with elegance and euphoria—take the life of a human being. Riding the coaster’s track, the rider is subjected to a series of intensive motion elements that induce various unique experiences: from euphoria to thrill, and from tunnel vision to loss of consciousness and eventually death. Thanks to the marriage of the advanced cross-disciplinary research in aerospace medicine, mechanical engineering, material technologies and of course gravity, the fatal journey is made pleasing, elegant and meaningful. Celebrating the limits of the human body but also the liberation from the horizontal life, this ‘kinetic sculpture’ is in fact the ultimate roller coaster. John Allen, former president of the famed Philadelphia Toboggan Company, once said that “the ultimate roller coaster is built when you send out twenty-four people and they all come back dead. This could be done, you know.” [Source]

If that’s whetted your appetite to find out exactly how the Euthanasia Coaster kills you thrillingly, go visit the blog.

Here’s a roundup of news stories I’ve tweeted in the last fortnight. It looks rather a lot — but I try never to fob you off with quantity at the expense of quality. I hate having my own time wasted, so I try hard not to waste yours. Take your pick and enjoy — or gobble the lot and gorge yourself.

Before you do, though… If you missed last night’s Dispatches on end-of-life care, do catch it on 4OD. I don’t know what you’ll think of it — or did, if you’ve seen it. For me, it was the contrast with the care given to those at the start of life that most struck me. We don’t have elders in our society, it seems, only disgusting old people.

Upgrade work at Shrewsbury crem ditched. Aren’t crems easy targets of cuts?! http://bbc.in/dK68PX

Satan’s undertaker’s online memo site is http://bit.ly/eRn1HT Is it any relation of this: http://bit.ly/ebnw8e? Wha gwan?

Priest makes off with bones of child saint - http://bit.ly/gCyKd4

“The Freudian implications of filming a sex scene in the shadow of a soaring obelisk” - http://bit.ly/g4fTKF

Some interesting #funeral industry analysis here- much that is typical - http://bit.ly/elobdS

“Now that I’m dead, I want to tell you a few things.” Last letters. I love this site - http://bit.ly/cRpFuX

DeathRef Death Reference Desk

by GoodFunerals

Happy Valentine’s Day darlings. http://fb.me/T6DJ7iOE

What’s the fuel cost of a cremation in the UK? Guess! Okay, I’ll tell you… £16.25

Lovely topical mezzotint on the Morbid Anatomy blog today – of two dissected hearts. Typical! http://bit.ly/eI5iHw

Nice wheeze for a floral eulogy here - http://bit.ly/hqaHTd

Bio-cremation “could warp metal pipes and burn crematorium workers” - http://lat.ms/i2d1m3

Bad guys always go to the funeral. That’s the place to arrest them -http://bit.ly/ekDmpj

The Top 20 Most Inappropriate Songs To Play At A Funeralhttp://youtu.be/MkYXS4CDU6Y

Really nice sendoff here culminating in a Viking funeral for the ashes – http://bit.ly/gugn2j

My Big Fat Gypsy Funeral? I’d like to see this - http://bit.ly/eYplL0

Malidoma Some and the power of ritual. A great man. Catch him here: http://bit.ly/eY9h8T

“Trad Brit stiff-upper lip has melted into a wobbling lower one.” Is modern grief incontinent? http://bit.ly/hXrfKA

Click on ‘Progressive Conservatism Project’ at the Demos website and you’ll get this: ‘That page could not be found’ !!!

“The great thing about being old is that you don’t give a bugger about people’s opinions anymore.” Dolly Frankel.

Very good booklet here from cancer.net spelling out for terminal patients their end-of-life options - http://bit.ly/fflu8r

“E’body wants a good death but not a moment too soon, but they don’t have the language to ask for it.” http://bit.ly/g3JWCW

“I knew something was terribly wrong with my marriage when I planned my husband’s funeral.” Great first line! http://bit.ly/eDVnEY

“Webcast funerals are dehumanizing – the necessity of human contact requires the physical presence of mourners.”http://bit.ly/eUYVQT

A classic illustration of the systemic incapability of corporate FDs to provide a good service - http://wapo.st/gh1pMf

Would the sale of Bretby crematorium amount to ‘privatising death’? Well, it’s a good question - http://bit.ly/ekH9jp

’26 babies buried together in a wooden box along with unidentified limbs and bones.’ They do this in the US. Shame!!http://huff.to/gaBdyu

Teacher makes her final journey in her VW camper van. Touching story, this - http://bit.ly/faIUHh

‘So recently directing medical care, now we are awkward bystanders.’ Hugely humane doctor’s response to death -http://nyti.ms/hbx8iC

RIP trolling. New to me (but maybe not to you) - http://bit.ly/hf2ikY

What’s responsible reportage and what’s voyeuristic grief porn?http://bit.ly/hIehDs

Mourning glory – the Banshee. Real or myth? Good stuff here -http://bit.ly/gY7nH4

The family is dead? 368 direct descendants at funeral of L’pool matriarch – 17 lims followed the hearse - http://bit.ly/hq6rMz

A funeral at a rugby ground. Great venue, great sendoff -http://bit.ly/gBs9F1

2 biggest comps you can pay an FD: You look nothing like an undertaker; this place is nothing like a funeral home -http://bit.ly/eKUEVm

Some very touching condolence messages on this online memorial site - http://bit.ly/e68jq3

Interesting reflections by ASD folk on weddings and funerals -http://bit.ly/eJyc8d

Great story here + pics: the funeral of racehorse Man o’ War, embalmed (23 gals) and casketed - http://bit.ly/idcYp0

StNeotsFunerals Andrew Hickson

by GoodFunerals

Our new Funeral Price Estimator is up and running online. Open and honest and proud of it.http://www.kingfisherfunerals.co.uk/costs.html

US undertaker offers end-of-life workshops. I like this.http://bit.ly/erO8zM

Love this irresistible free offer from the Neptune Society -http://bit.ly/i86PaI

‘After my sister died I went through her computer and deleted everything questionable so my parents wouldn’t find it.’http://bit.ly/fgqYzN

Online memorial site of the day: last-memories.com. Great twinkly backgrounds. And it’s free! http://bit.ly/fC1V7y

Oh dear, SCI in the doo-doo again. Are these big corps systemically inept? http://bit.ly/fPq7mh

Good piece in the HuffPo here on end-of-life planning -http://huff.to/gqZDUF

DIY suicide causes horrible death, claims EXIT. Time to legalise? http://bit.ly/ffDoI1

Oz police shut the pubs when there’s an Aborigine funeral in town. Racist? http://bit.ly/eIrtbE

Every week in the Spectator magazine Peter Jones takes an occurrence or development in contemporary society and politics and considers it in the light of what the ancients did when faced with the same circumstances. This week he considers the art of dying. I’d now bung you a link but I can’t: the Speccie does not unleash its content online til it has gathered some dust. The joy of the Spectator lies in the quality of its writing (sadly not its politics). It’s almost worth the cover price for Mr Jones alone. I hope he won’t mind a quote-strewn precis.

He begins:

“So everyone is going to live much longer and will therefore have to work much longer to pay for their pensions. But what is so wrong with dying, Greeks and Romans would ask?

“Homeric heroes sought to compensate for death with eternal heroic glory … Plato argued that the soul was immortal. The Roman poet Lucretius thought that was the problem. For him, life was an incipient hell because of man’s eternal desire for novelty. So as soon as he had fulfilled one desire, he was immediately gawping after another. What satisfaction could there be in that? The soul was mortal, he argued, and death, therefore, should be welcomed as a blessed release.”

Cicero concurred. We run out of things to interest us and are glad to go. “A character in one of Euripides’ tragedies put it more succinctly: ‘I can’t stand people who try to prolong life with foods and potions and spells to keep death at bay. Once they’ve lost their use on earth they should clear off and die and leave it to the young.’

“For Seneca the question was whether ‘one was lengthening one’s own life — or one’s death.’ “

Jones concludes: “Marcus Aurelius put it beautifully: ‘Spend these fleeting moments as Nature would have you spend them, and then go to your rest with a good grace, as an olive falls in season, with a blessing for the earth that bore it and a thanksgiving to the tree that gave it life.’”

Assisted dying, self-deliverance, euthanasia and allowing people to die naturally – all these are hot topics which can only get hotter. I’ve just had this email from CareNotKilling, and anti-assisted dying org:

Channel 4 are giving you the opportunity to voice your views on a series of short films about euthanasia, which are being shown on Channel 4 next week.

Next week ‘4thought.tv’ are exploring attitudes towards euthanasia, and asking whether it should be legalised in Britain.

The 90 second films will be airing after the news every evening on Channel 4 (around 7:55pm) next week.  Viewers can then share their own thoughts and feelings about euthanasia, respond to the individual films and reply to other viewer comments on their website www.4thought.tv

Channel 4 are interested in all thoughts related to the films, whether you agree with the speaker or strongly oppose what they say, and hope people will also share personal views and and experiences.

This is a great opportunity to make your views known on such an important issue.

Please watch and respond to the films online by going to: http://www.4thought.tv/

I’d not come across this Channel 4 slot before, and as I surveyed the schedule I reckoned I probably wouldn’t be able to make time to watch most of them. No worries. I can watch them online later and I can still leave a comment. I’ll be doing that for sure.

Over at the Exit blog I read this:

The religious right are already organised: the Independent Catholic News is urging people to respond online and the Church of Scotland is using its blog and facebook. The pro-choice lobby represents 80% of the population, yet when it comes to expressing our thoughts we are way behind. [Source]

Reading that after getting my email from CareNotKilling, I can see what they mean. Exit wants those who support its cause to be sure to get online.

Whichever side you’re on, you may want to do the same. Here’s the schedule:

Lesley Close – sister of an assisted suicide
Monday 17 January, 7.55PM on Channel 4
Lesley Close’s brother John had motor neurone disease. In 2003 Lesley accompanied him to a suicide clinic in Switzerland where she witnessed his ‘dignified and amazing’ death.

Martin Amis – luminary of the literary world
Tuesday 18 January, 7.55PM on Channel 4
Author Martin Amis believes that euthanasia is an evolutionary inevitability. Martin caused controversy by putting forward the idea of suicide booths on street corners and thinks that future generations will look back at how we have abandoned people to their longevity as ‘barbaric’.

Motor neurone disease makes my life richer
Thursday 20 January, 7.55PM on Channel 4
Michael Wenham was diagnosed with motor neurone disease. He believes his life is now richer than it was before his illness and that euthanasia is a selfish act that fails to take account of the feelings of those who are left behind.

A right-to-die activist speaks out
Friday 21 January, 7.25PM on Channel 4
Dr Michael Irwin believes that it is a doctor’s duty to ease a patient’s suffering and wants to see a change in the law that would allow doctor-assisted suicide for those who are terminally ill. He has personally accompanied patients to the Dignitas suicide clinic in Switzerland to help them end their lives.

A terminally ill doctor speaks out
Saturday 22 January, 6.50PM on Channel 4
Dr Ann McPherson has terminal cancer. Ann hopes that, when the time comes, she will be able to have the option of an assisted death in Britain.

A Sunday opponent hopes to round things off
Sunday 23 January, 7.55PM on Channel 4
Kevin Fitzpatrick believes that legalising euthanasia in Britain would be a terrible mistake and that many more disabled people would die as a result. Kevin believes that we should put our energies into improving palliative care services rather than trying to make it easier for people to hasten their deaths.

There’s a report just out from Demos on death and dying (why don’t we get chronological and say dying and death?). It’s by Charles Leadbeater, somewhat of a hero of mine, and Jake Garber. It’s called Dying for Change. It comes out at the same time as the National Council of Palliative Care’s The Missing Piece: Meeting People’s Spiritual Needs in End of Life Care. I’ll talk about the latter another time. I would only make the observation now that the 136pp Demos report is free to download; the 20pp NCPC report costs a bloody tenner.

Here are some extracts from the Demos study to whet your appetite. The scope of the full report is wider and, of course, fuller. It also offers radical alternatives to the way we do things now. Leadbetter begins by describing the death of his father:

Bill’s death was not a tragedy. He lived a long, happy and healthy life. Some of that life he owed to interventions by the medical profession: operations to fix his knees and sight.

Without modern medicine he would not have been alive at the age of 86. Yet the medical profession that had extended his life was unable to provide him with a good way to die.

Around threequarters of deaths in the UK are ‘predictable’ and follow a period of chronic illness. Dying has become protracted,complex and painful.

Unless we can devise ways to get people to talk about how they want to live while they are dying, our efforts to improve services will be like groping in the dark. It should become standard for people reaching the end of life to create advanced care plans with

the help of friends, family members, trained peers or professionals. Evidence from the USA suggests this can dramatically reduce unnecessary admissions to hospital and

improve care.

· Training in palliative care needs to be much more widespread among doctors, nurses and care home staff at large. Too few doctors, nurses and care home staff are ready to have open conversations with people about the prospect of death and how they want to die.

· We should draw on the models of federated schools to link hospices to groups of care homes, so that hospice skills and values can migrate into care homes.

· Services should be commissioned by end of life trusts in an integrated way that bring together public, private and voluntary providers within a community.  – £500 million pa

Our challenge is to help people to achieve what is most important to them at the end of life. That will require the creation of a network of health and social supports so that people can die at and closer to home, with the support of their family and friends, as well as professionals.

If we do not create this social network, then in the decades to come many hundreds of thousands of people will experience unnecessarily distressing deaths. We will die badly in places not of our choosing, with services that are often impersonal, in systems that are unyielding, struggling to find meaning in death because we are cut off from the relationships which count most to us.

Communities and families have coped cooperatively with death for centuries. Only very recently have we become heavily reliant on institutional, professional solutions – care homes and hospitals. There is mounting evidence that the services these institutions offer are costly and inappropriate. A lot of money is spent on public services that people do not want as they are currently delivered, and which are poorly designed to meet their needs.

Download the complete report free here.

Watch the full episode. See more FRONTLINE.

Superb if gruelling documentary examining end of life issues from PBS.

One of the contributors is Judith E Nelson, professor of medicine at the Mount Sinai School of Medicine and associate director of Mount Sinai Hospital’s Intensive Care Unit:

The burdens of intensive care can be very, very heavy, and the outcomes are often not good. So we have to face this extraordinarily difficult challenge of knowing when to use this miraculous technology and for how long and knowing when to try to preserve for people a peaceful and dignified process of dying. Walking that line is the very hardest part of my job, and constantly recalibrating myself from one side of it to the other.

Although we can never be 100 percent certain until the moment of death that someone is dying, there are clinical situations where the odds are so overwhelming that someone can['t] survive the hospitalization in a condition that they would find acceptable, that we can see that outcome and compare that with the burden of the treatment. When it is virtually a foregone conclusion that that unacceptable outcome is going to occur, then using this technology to support the physiology of the patient doesn’t make sense. And it is invasive, and it’s burdensome.

It’s a situation in which a person is completely dependent for all of their care on a nurse and a physician; where the patient cannot even attend to their most personal care and has to be cleaned from head to toe and every place in between by another individual; when they’re not even awake. And our nurses do that in the most unbelievably respectful way, but still, it’s a part of this experience. It is being attached to machines with constant noise from alarms and signals. It is being surrounded by electrical devices and monitors, with no control over any of your bodily functions, quite literally. And although we strive as hard as we possibly can to prevent discomfort, it’s probably impossible to prevent it at every moment. So there are discomforts, and one hopes rare but occasional pain and other kinds of distress, fear, delirium. All these things are occurring for people.

In addition to that, you’re in a bed that has side rails to protect you from falling, but also may make it more difficult for the people who love you to get close to you. Even if there’s open visiting in an ICU, which some ICUs have and some don’t, it is not a place where loved ones move about freely. They’re uncomfortable and unhappy and fearful. And all of that is part of the surrounding. So it’s a very disconnected, depersonalizing and occasionally even painful and frightening experience. I don’t think anybody wants to die that way. I think most of us, not everybody, but most of us would be willing to go through it for a good outcome, but nobody wants to be like that if nothing good is going to come of it.

Full interview transcript here.