When to talk about death and dying?

A friend chastised me for being too quick to bring up the subject of death and dying with people who are suffering from a terminal illness.  “Here they are, dozens of friends and loved ones, encouraging hope for recovery, and the first thing you do is ask them what they think about dying.  That’s not helping!”
She had a point.  When it is clear to me that someone under my pastoral care is approaching the end of life, I am not shy about bringing up the subject of death and dying with them, but she wonders how it can be clear to me if the doctors are still offering options for treatment.  What gives me the right to bring up a subject that no one else wants to bring up?
It’s a ticklish question, and a good one.  I’m not sure what makes an approaching end of life clear to me.  It may have to do with how well I know the person and his or her family, the history of their illness, and the content of our private conversations during times of pastoral care and prayer.  There is a sense that they know what others don’t, and that they have urgent questions about the path they are on, questions about God and faith that have been rattling around in their minds for decades and are only now being formed into words.
They are not the questions that theologians have batted about for centuries.  They are more likely questions formed in their Sunday School years, from conversations with friends in daily life, from long suppressed anxieties and guilt, or just plain curiosity.  They are not questions that are given a chance to be expressed in an environment of decisions that have to be made about treatment, or with friends and loved ones who seem to seesaw between optimistic talk of recovery and overbearing sighs and tears of sympathy.  Among them, the most sincere and least helpful are good Christian souls who enthusiastically endorse a cheerful hope in miraculous healing in the firm belief that, for faithful Christians, there is no such thing as a terminal illness.

I certainly don’t go barging in where I have not been invited, and I try to deal with the questions and concerns they have, and not the ones I think they should have.  While I always offer the sacraments of the church as a part of whatever time we have together, I’ve also come to recognize that sacramental moments are present without the presence of liturgy or prayer book, most often in what we might otherwise call ‘reconciliation of a penitent.’  In the context of Christian ministry, It seems to be important to some people, as they approach the end of life, to know that another human being is there to walk in hope with them a part of the way, someone who will introduce them to the nearer presence of God in Christ as the one who will walk with them all the way.  It’s a time salted with tears and laughter, often more of the latter.  So there you have it.

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