Harvey Max Chochinov's book shows how to treat the terminally ill with true compassion
I only discovered Dignity Therapy by Harvey Max Chochinov recently, though it was published by OUP in 2012. It is subtitled “Final Words for Final Days” and what I like about it particularly is that it presents a subtle and powerful argument against euthanasia without in any way being overtly religious. In other words, it should appeal to fair-minded secularists who have no time for the line taken by Christians that, as we come from God, only He has the right to ordain when our lives should end.
I do not know the author’s own religious affiliation (if any) but given his preface is a moving meditation on the death of the patriarch Jacob in the Old Testament and in one passage in his book he writes “According to the Talmud”, I can make an educated guess. They suggest he comes from a tradition that has always cherished ancestry, tradition, reverence for the written word and for close family ties.
This, in a way, is what Dignity Therapy is about: an “individualised psychotherapy” aimed at those with life-threatening or life-limiting conditions, it seeks to encourage them during a series of recorded interviews to reflect on their life as a way of leaving a permanent legacy for their family. The act of reflecting and responding to questions makes the patient feel respected, listened to, understood – and the sense of hopelessness and inner despair that often accompanies the wish for euthanasia is removed.
Questions include, “When did you feel most alive?”, “What are your hopes and dreams for your loved ones?” and: “What have you learned about life that you would want to pass on to others?” The method is intrinsically life-enhancing and the very moving testimonies of some of those who have taken part in this therapy show how much it has helped them to retrieve their dignity when, within a hospice or hospital setting, deprived of their “normal” lives and subject to invasive and frightening treatment, they feel it has been taken away from them.
According to Chochinov “Every person has a particular psychological makeup and spiritual outlook that shapes his or her worldview and response to opportunities and crises.” He cites the book ‘The Diving-Bell and the Butterfly’ dictated through blinking an eyelid by a Frenchman, Jean-Dominique Bauby, who had “locked-in syndrome” after a catastrophic stroke, to show how the mind can be alive and responsive to the world despite extreme physical paralysis.
When he describes how Dignity Therapy can provide “comfort, offering moments of human contact, love, celebration, humour, affirmation and on occasion, even reconciliation”, the author could be giving a therapeutic version of the Christian concept of the “sacrament of the present moment.” A Christian might respond to the book by saying it is already encompassed by the old word “charity”.
Yet human dignity in its true and spiritual sense has to be protected in our secular society from its undignified hijacking by the “Dignitas” movement. Chochinov’s book goes a long way to doing just this.