The Art of Dying and Living

Aid in dying and personal autonomy

Title of the german book: Leben- und Sterbenkönnen

Published in German by Peter Lang Publ., Jupiterstr. 15 CH-3000 Bern 15 –
Tel: ++41 (31) 940 21 21 – Fax :++41 (31) 940 21 31, http:// ; 874 pages,

Abstracts of each chapter


Didactic reading support: By spotting the easily discoverable italicised passages throughout the book (the first passage is at the beginning of the Eingang), the hurried reader, who has the courage to test his German knowledge, may grasp within two or three hours some key features of the treatise — The informally written law proposal: A sociocritical case study — Methodological considerations which are demonstrated by some relevant examples

1. Aid in dying and its legal solution

Every competent person should take a position with regards to a living will — Palliative care which will replace ” passive help in dying ” must be extended throughout the health system — Assistance in suicide: An extreme solution on the outer edge of palliative care — Active euthanasia on patient’s request is admitted only if help in suicide is no longer possible — Outline of a legal solution: Utopia or near future? — Dignity is not an equally shared attribute among all humans; dignity is the reverence within human relations towards the weaker — But what about self-identity and autonomy, the inalienable right of the free person?

2. Autonomy and living will

In defining autonomy, concepts such as social value, suicide, social status and as existential problem are put into a systematic theoretical framework — Autonomy and integration are fundamental sociobiological trends which can be reflected on the human value level by the two Christian love commandments — The love for one’s fellow-man refers ultimately to the autonomy that should be fostered in another; fair equality of opportunity: the social counterpart of autonomy — The love for a supreme power refers to an ultimate providential integration: the precaution for the future is the social counterpart of integration — The polarity of autonomy and integration gives rise to a tension within the social sphere which can be illuminated by the example of the elderly status — The personality theory destined to clarify self-identity and personal autonomy is absorbed by a general theory of group behaviour — The persecutor-victim-saviour triangle sets forth the basic structure of the out-group behaviour — The persecutor who proceeds without violence is a seducer — For the in-group behaviour, supplication, invention and aggression are prevalent — Power and its intimate link to the social status — A sociocritical approach to power which will reveal its benefits later on — Self-identity and autonomy cannot be exhaustively accounted for by the different types of social status; to do this, the role behaviour must be explored

3. Role and self-identity

Most roles transcend social status — What exactly is the difference between our daily role behaviour and the role playing of a stage actor? — Role performances are bound to be evaluated — Performances and, jointly, expectations bring autonomy and fair equality of opportunity back into the focus of discussion — Fair equality of opportunity is cast into a precise conceptual frame which is used for a rigorous critique of power — fair equality of opportunity can be implemented in society only if power is not overprotecting itself or, on the contrary, dissolving within the social sphere — The role play makes it possible for us to prepare difficult life passages, especially the last one: dying — Self-identity cannot be exhaustively accounted for by the different types of social status and the role analysis; to do this, pain behaviour must be explored

4. How long and how much must pain be endured?

The meaning of pain and suffering originates from a cultural attitude towards the principle of deferred gratification — The sick society — A comprehensive investigation into the healthy, the ill and the dying person — The patient-doctor relationship is brought forward thanks to the group behaviour results of chapter 2 — Some pain types, their function and dysfunction — Help in suicide, final letting go or terminal delirium provoked by the palliative drug cocktail? — When and for how long should pain be calmed down? — Some basic arguments about pain that might challenge the disciples of Wittgenstein — What is going on when I determine my own pain limits? What does it mean to classify pain as tolerable or not? — General approval of the Swiss Exit-Manual written for patients requesting aid in suicide: The eight steps of this Manual leading to the informed consent of the patient as well as the American approach of T. Quill are put forward — The phantom of active euthanasia is lifted — Self-determination still cannot be exhaustively accounted for by the different types of social status, the role analysis and the pain discussion; to do this, we must investigate the social meaning given to suffering

5. Suffering

Every religion provides to its faithful a specific coping strategy against suffering: God helps, therefore he exists — An enlightened religious strategy struggles against sufferings that originate from our denials and repressions, it brings relief to our anxiety arising from non deniable sufferings and it opens up the way to the suffering we can positively accept — The illusions of sanctifying sufferings: A certain Christian conception of suffering is demystified and rejected as well as its correlate, the absolute interdiction to suicide — Why not interpret the Christian core message as a form of social critique? If so, then the radical self-questioning of the powerful, which will improve the situation of the weaker, becomes the central theological aim — The critique of power of chapter 2 unexpectedly finds therefore its theological extension

6. The history of the crucified Christ reconsidered

The persecutor who has become a seducer, captures his victim without violence: the results from the group behaviour discussion of chapter 2 and 3 find their application within theology — However, for staying truthful, the seducer must be committed to an authentic approach by offering a gift to his victim who in return becomes his saviour. Through this process, the initial victim has undergone a self-discovering process — The untruthfulness of seduction appears in the temptation which leads the tempted astray, manipulates himself and his victim — Social power becomes the supreme temptation for all the powerful who refuse their radical self-questioning — The reinterpreted crucifixion reveals the basic structure of the scapegoat mechanism – Those who follow the Christ have accepted to cover up victim processes and to eliminate them – When he created man, God questioned himself radically through an act of love – Jesus is the instrument of reconciliation of this ultimately godly selfquestioning – The powerful who manage to settle escalation of a conflict by transforming it into sustainable assent have shown humility in order to let the demand for forgiveness grow – Christian foudations of general ethics are developed within a social critique inspired by the theology of liberation

7. Autonomy and reconciliation through forgiveness

Thanks to the Christological approach of the previous chapter, the general yes to the living will is to be encouraged as well als the yes to aid in suicide within its boundaries as described in chapter 4 – No theology can bring concrete support to the dying; only the mystical force of religion can do so by calming down emotions – Preliminary considerations towards a reneved christian art of dying – Prayer and fasting during a lifetime: itts impact on the art of dying – Faith, hope, patience, humility and loveare spiritual complements to the emotional stages proposed by E. Kübler-Ross – spiritual letting go: a way of dying

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