Burdened Agency: Christian Theology and End-of-Life Ethics addresses the problem of death and dying through Christian theology and ethics. In previous centuries, death was something that simply “happened” to us. However, due to advances in modern medicine, individuals are increasingly required to make concrete choices about the nature and timing of death. Travis Pickell offers a historical and philosophical account of the origins of our situation of burdened agency, as well as a Christian solution to the problems that it raises.
Our own society does not deal very well with death and dying. Some suggest that this is the result of widespread cultural attitude of denial. Arthur C. McGill, for example, characterized contemporary America as a nation of bronze people who “live according to an ethic of success or avoidance . . . devoting themselves to expunging from their lives every appearance, every intimation of death.” In advertising and popular culture, this ethic of success is reflected in portrayals of old age and retirement that resemble a second adolescence, a period of time apparently free of bonds of responsibility, in which leisure is pursued with carefree abandon and romance blossoms in ways that are impossible in the midst of work and family life. I do not want to suggest that freedom, leisure, and romance are not desirable features at any stage of life—I hope to have my fair share of each even into old age! Nevertheless, the one-sided portrayal of this ideal betrays a cultural discomfort with the ambiguous realities of aging (the loss of mental acuity, for example, or the gaining of folds in the skin) and the eventual fact of death which these portend.
There are, however, plausible reasons to question the notion that the American attitude toward death is primarily denial. The cultural landscape is complicated. In fact, there seems to be a resurgence of attention to death and dying in the popular media. A couple generations ago, the “death awareness movement” brought death and dying into the light, largely fueled by a shared recognition that the combination of death’s medicalization and its erasure from public consciousness was resulting in an undesirable state of affairs. The type of death which was growing increasingly likely—a death marked by loneliness, social isolation, and overuse of technology—was widely recognized as a “bad” death. In the past few decades much has changed, but much has also remained the same. Today, major motion pictures and New York Times best-selling books and memoirs are increasingly focusing on the end of life, and there seems to be a steady proliferation of newspaper and journal articles exploring the ethical ambiguities of death and dying. Self-proclaimed “transhumanists” have initiated a (still nascent) public debate about whether, if we were able to do so, it would be desirable to cure the “disease” of old-age, ushering an era of radical life-extension. In some cities “death cafes” are now commonplace. At these public dinners, participants gather to consider their mortality and share their fears and desires for the end of life. It seems like death is finally getting its due. As with the original “death awareness movement,” however, this widespread attention reveals a general dissatisfaction with the institutions, practices, and cultural influences surrounding death and dying in our society. A book like Atul Gawande’s Being Mortal is likely only a wild success in a culture that struggles with being mortal.
Perhaps the most confounding aspect of dying today is the fact that it increasingly must be chosen. Death used to be generally understood as something that happens to us. In previous eras, a chosen death was an exception to the rule. The soldier throwing himself on a grenade to save his comrades or the dramatic suicides of Shakespeare’s Romeo and Juliet inspire and move us in their tragic or heroic rarity. But when the dying process is enveloped by the ever-increasing power and dominion of medicine, the exception becomes the rule: today we are more likely than ever to choose the manner and timing of our deaths (or the death of a loved one). In the illustrious words of Sir Winston Churchill (or was it Spiderman?), with great power comes great responsibility. It is far from clear, however, that such responsibility is welcomed by the average person.
(excerpted from introduction)