Catholic Medical Quarterly Volume 70(2) May 2020
With the End in Mind - by Kathryn Mannix
Reviewed by Andrew Plasom-Scott
In the Letter to the Hebrews, in the passage read on the Feast of the Presentation, we are told that St Paul writes: Jesus... set free all those who had been held in slavery all their lives by the fear of death.
Timor mortis, the fear of death, is salutary in one sense: if it makes us meditate on the four last things and prepare for a good death. But if it is the fear that paralyses, the fear born of ignorance that tempts us to denial, it is clearly bad. It is to combat this evil, I believe, that Kathryn Mannix has written With the End in Mind: Dying, Death and Wisdom in an Age of Denial.
Mannix is a retired doctor who has specialised in palliative care, and has witnessed at first hand, many times over her career, how people approach death; both the dying and those who are with them: friends, family, carers, and medics. Her thesis is that our modern taboo about talking about death is deeply unhelpful, and she confronts this by telling many true stories about death and dying, again drawn from her extensive experience.
Her primary message is that death is normally both a peaceful and a predictable experience, and she describes the normal process of dying very simply and clearly. Further, she demonstrates time and again, through her stories, how helpful it is for both the dying and those accompanying them to know this: to know what to expect and how to interpret what they experience.
When it comes to the question of euthanasia, she is carefully balanced in her comments, above all pleading against the strident rhetoric that is sometimes heard on either side of the argument. The story she presents, however, speaks loudly and clearly about some of the less obvious risks of legalised killing. She tells of the overwhelmingly negative impact that repeated suggestions that he should consider whether he wanted to hasten his own death had on a dying man, Ujjal. Eventually, Ujjal left the Netherlands because of this, and came to England to die in peace. In this way, she often lets her stories do most of the work in her teaching.
This is a powerful, honest and compassionate book that will be of great value to all in the medical and caring professions who work with people who are dying; but also to all of us, as in our common humanity, we will inevitably experience the death of those we love, and ultimately our own and we will be better prepared for both by the wisdom shared by Kathryn Mannix.