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Death is Spiritual: Part 2, Permission

When we are ready to die, we need permission. While dying happens in accordance with what the divine wants, our souls need permission to move on, to let go. It’s a jarring phenomenon, but we in hospice often see how souls can be trapped in the dying process, that dying can be drawn out in an unfortunate way because the patient has not been given soul permission to move on. The patient will eventually pass, but the denial of death imposed by the living “loved ones” leads to increased suffering for all. 

As an example, we had a patient whose spouse had just passed. The patient was grief stricken and shortly after the spouse’s death, the patient wanted to pass. The patient began letting go, but the family was adamantly against the patient’s dying, especially so soon after the spouse's death - it was too much to think of losing both parents back-to-back. The family insisted that the patient would not die on their watch, they were not ready to hear the word death, and sent the patient to the hospital. The patient was diagnosed with COVID-19 and with treatment, the family confidently announced that the patient had been saved.

Yet the patient came home and continued to prepare to die. The family could not understand why the patient was still letting go despite being fixed. They kept expecting the patient to get right back to living, but instead the patient declined over weeks and died. Most sadly, the family, in hoping so hard to keep the patient alive and prove the facts wrong, denied the patient all forms of comfort, for fear these measures would tip the balance and cause death. They believed the fallacy that comfort measures would expedite (not soften) death.

But no, comfort doesn’t hasten death. In those who are spiritually ready to pass, it smoothens out their trajectory of dying, allowing for peace. This patient was ready to let go, but in not being given permission by the family and thereby not being permitted basic comfort measures, was forced to drag out dying over an excruciating period.

Of course one could argue, this patient had the blessing of more time on earth. But in saying such, who really benefitted from this short extension? Was this extended time something that truly gave quality to the patient or rather fed the ego of an unrealistic family? Again, the reality was excruciating: day after day the dying patient was pushed beyond capacity, choking with intake; grimacing with movement; defecating in severe, agited confusion on the bed. Is this the quality of life we would like for our loved ones at the end?

Permission is critical for our patients.  Not allowing them to die because we are not ready, because we ourselves are not in order, because we are self-centered or blind to reality is cruel. When patients are spiritually ready to pass it is not our place to interrupt them. We are here to recognize where they are and what they need, to minimize their suffering and guide them with comfort into their next iteration. Disallowing permission doesn’t really change of the course of death; it only causes suffering of a ready soul.


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