Monday, April 13, 2009

Work towards peaceful death

Work towards peaceful death
Mon, Apr 13, 2009
The Straits Times

Health Minister Khaw Boon Wan (above), 56, a Buddhist

"To me, after a full and fulfilling life, a departure without pain, suffering, in the company of loved ones, in one's own home, completely at peace with myself would be dying well.

But such a peaceful death does not happen naturally. It has to be worked at.

For some, it starts with realising that the current life is merely transient, a journey to a better final destination.

Alas, many people confuse the temporary with the permanent and cling on to material things, causing much suffering to themselves and others.

My father, who ran a small business, died a good death at 81. He went into a coma after suffering from a brain haemorrhage in front of the television and drew his last breath a few hours later.

He had lived a full and active life and brought up his eight children well. He was honest, with no vices, and was responsible and caring.

He was not rich materially, but richer than most spiritually.

His sudden death was, of course, painful for the children to bear initially.

But deep inside, we all wish that when our time comes, we will similarly pass away painlessly and suddenly in such a manner, rather than being bedridden and suffering pain for months or years, with little quality of life.

Maintaining a healthy lifestyle is crucial. It does not guarantee no suffering at old age, but enhances our chances of being able to live and age well.

We should have a mature attitude towards death, acknowledging it as a natural part of life. Making it a taboo subject will only make the dying process worse.

I am glad that this is slowly changing and many Singaporeans can now discuss death openly and comfortably, without feeling "pan tang" or superstitious. We should "die-logue" more and then act on it by preparing for our eventual departure."

Dr R. Theyvendran, 64, a Hindu and well-known Tamil community leader, is chairman and managing director of printing, publishing and trading firm Stamford Media International.

"Death is inevitable. We have to be prepared to accept it as part of living.

To die well, you must live well, striving to make a better life not just for yourself but for others too.

My father's death was a good example. A retired civil servant, he died about 20 years ago at 63 in my mother's arms, with no suffering.

He raised all his 10 children well and with the right values, on how one should go forward to help others in need.

Death is not the end. As a Hindu, I believe in reincarnation. I believe you will return once more and get a chance once more to do good in life.

So death is just like changing clothes. In the next life, one may be back to do more and better things, fulfil other desires that could not be achieved in this lifetime."

Dr Noreen Chan, 42, a Buddhist, spearheads the palliative care programme at the National University Hospital.

"My views about death and dying have changed. I used to think that I should be helping people "accept" their situation, and would get frustrated if they chose not to. Then I came to realise that we die much as we live, and the beliefs and habits of a lifetime don't change just because you get a lethal illness.

The notion that somehow we have this epiphany and everything falls into place makes for a nice movie. But in reality, we all struggle to find meaning.

If I could choose my terminal illness, it would be something long enough for me to tie up loose ends, say goodbye, do something nice - like go on a special trip, but it's OK if I can't - and yet not so long that I feel like things are dragging.

I'd like to be as comfortable as possible, surrounded by love and laughter, not be subjected to interventions that don't add to my quality of life and, when my time comes, be allowed to pass on peacefully."

Mrs Ann Wee, 83, who helped pioneer social work here, is a Christian and former head of the Department of Social Work, National University of Singapore. She still holds an honorary position with the department.

"The 17th-century English preacher and writer John Bunyan wrote: 'Please Dear God, Let me be alive till I die.'

I think it's a beautiful phrase that encompasses what a lot of us feel. We want long healthy lives, a short period of illness, and then off we go. Geriatricians call this a 'rectangular' life. No one wants a long, slow deterioration.

I am grateful that both my parents who lived in a village in north England went quite quickly after they fell ill.

For my father, it was instantaneous. He was an avid gardener and one morning he was checking the temperature gauge in his garden and he just fell down and was gone. He went doing something he enjoyed.

It was extremely difficult for my mum at first, but she eventually realised that he would have hated being a patient, so in his case, it was a blessing in disguise.

My mum lived to her 90s. The doctor gave us some warning by telling us she was winding down. She too was aware of it. She told us she had had a good innings - using a phrase popular in cricket - and that we were not to mourn her.

I think it is good to talk about death and dying, but not when it is imminent, unless the dying person initiates the conversation.

It is also important to view the dying process as an important part of life. I get a feeling that death is nowadays treated as something of an obscenity in England, where I grew up. The British abhor death.

I am glad that is not the case in Singapore. Singaporeans are comfortable with sickness and dying. One good thing is many don't hesitate in having children around sickness. This not only cheers up the sick but the kids too grow up knowing that dying is just a part of the normal life cycle - which is how it should be."

Hajah Fatimah Azimullah, 63, is a Muslim and immediate past president of PPIS, or Young Women Muslim Association - the oldest Muslim women's group here. She is also involved in community organisations such as Mendaki and the Pertapis girls' home.

"For me or any Muslim, dying well means to die 'in Islam', meaning believing in Allah and the Prophet Muhammad.

An aunt died last year at the age of 84. She was getting weaker and weaker and when taken to the hospital, refused any kind of invasive treatment.

She was given medication to make her comfortable and died at home in the presence of family members. I consider her death a good death. It gave her close family members time to accept her death calmly.

Death is something we Muslims accept as the will of God. So, however and wherever one dies, it is something Muslims accept."

Professor Wang Gungwu, 78, is an eminent scholar of Chinese history and chairman of East Asia Institute, National University of Singapore. He has no religion.

"The ideal thing is to die in your sleep with your mind still functioning normally and your body reasonably healthy. But that is probably asking for too much.

We must also not fear death, knowing that it will come to all of us. Therefore, we must do what we can to ensure that our family and friends are not left with a lot of mess when we go.

Not to suffer too much and make your family suffer over a protracted illness would be the best. But we don't always have a choice there and must be prepared to accept death, however it comes."

Mr Imram Mohamed, 64, a Muslim, is a Malay community leader and chairman of the Association of Muslim Professionals. A retiree, he used to work as a senior airline executive.

"Dying well to me is, firstly, ensuring that I do not put any unnecessary burden on my family members whom I will leave behind.

As far as possible, I'd like to ensure that my finances are in order.

It also means that family members who are dependent on me will be adequately provided for.

To me, dying well also means to have lived a fulfilling life; that I have done my part in contributing to the community and that I have fulfilled my social and religious obligations...

Great men are remembered for their achievements but ordinary folk are cherished for their kindness, love and the joy they bring to others."

This article was first published in The Straits Times.

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