Rediscovering the “Ars Moriendi” by Xavier Symons

The Western intellectual tradition has as a central preoccupation the question, “what is a good life?”. The concept of the good life (eudaimonia) was a major theme in the writings of Ancient philosophers such as Socrates, Plato, and Aristotle. Interest in the topic was rekindled in the Christian era and again with the revival of Aristotelian virtue ethics in the second half of the 20th century.

By After Lysippos — Jastrow (2006), Public Domain.

One dimension of the question of the good life that received significant attention in the Middle Ages is, namely, the question ‘what is a good death?’. While the intellectual preoccupations of our current age are distinctive, there is still a deep existential interest in what it means to die well.

Of significant concern to modern sensibilities is the fact that some people are unable to spend their final days and hours in peace because of refractory pain. While modern medicine is effective at sustaining life, some terminally ill patients with uncontrolled pain are incapable of engaging in even the most basic activities. Since the start of the 20th century, more patients die from protracted illnesses involving ongoing suffering than from illnesses that result in a relatively short, albeit painful death. Furthermore, most Americans die in hospitals, surrounded by diagnostic machinery and doctors, rather than at home surrounded by loved ones.

How might we refine our thinking on what it means to die a good death? We can profit from considering how thinkers have approached this topic in centuries past.

One reason why scholars in the Middle Ages were concerned with the issue of dying a good death was due to the comparatively low life expectancy of people at this time. Life expectancy was somewhere between 30 to 40 years.

An anonymous scholar writing in the 15th century wrote a poignant tract on how to prepare oneself for a good death, entitled Ars Moriendi (Latin for ‘the art of dying’). The work instructs Christian faithful on how to prepare for their final hours on this earth. Readers are exhorted to be reconciled with their neighbors, to purify their souls of all ill intentions, and to attempt to make their peace with God. The short tract even counsels friends and family on how they should behave at the bedside of a dying loved one.

Ars moriendi — Wikipedia

Many people at the time, due to the sudden onset of fatal illness, would not have much of an opportunity to prepare for their death. But Ars Moriendi nevertheless provided broad guidance — through both written text and a series of detailed pictorial engravings — on the sorts of dispositions that one should have when approaching death. One should not fear mortality; one should beware of temptations to despair, impatience, spiritual pride, and arrogance. The dying process is essentially presented as a series of challenges, demonic in origin, that one must navigate. But if one can endure these challenges with optimism and humble faith, one will be assured of being accepted into heaven.

The text ends with a reflection on the need for a good friend at the hour of one’s death, to assist one with prayers and exhortations. It concludes with the lament that it is exceedingly difficult to find a friend who will act in this capacity. “But, alas! how few are there, who, in the hour of death, faithfully assist their neighbors with interrogations, admonitions, and prayers!”, the author writes. Indeed, it is suggested that one of the reasons why persons are not ready to die is because they lack a significant other in their lives.

One of the final engravings of the text depicts the soul, in the shape of a child, escaping the body and being received by an Angel. The imagery of childhood perhaps connotes the Christian notion of a dies natalis, or a birth to eternal life. Depicted below are the figures of six hideous demons, raging with disappointment at not gaining possession of the dying man’s soul by their cunningly-devised temptations.

A text like Ars Moriendi may at best be treated as an object of historical curiosity today. Yet it yields profound insights into how we as a society should approach the ‘problem’ of death. Death, after all, has retained its essential features, despite the seismic changes in the religiosity and intellectual culture of Western civilization since the Scholastic era.

Master E. S.Janez Höfler: Der Meister E.S: Ein Kapitel europäischer Kunst des 15. Jahrhunderts., Tafelband, Schnell & Steiner, 2007

Problems arise when we view the question ‘how ought we to die?’ solely through a medico-political lens. Debates about the legality of euthanasia or inadequate palliative care funding, for example, can ‘crowd out’ a deep philosophical consideration of what death really is and what dispositions we should have when we approach it.

If we reduce death to a medical and political issue, we remove from view the mystery surrounding our own mortality. Medicine and politics are practical sciences — techne, as Aristotle might describe them — in which we presume that the problems that we are dealing with are concrete realities that can be analyzed and solved at arm’s length.

Ars Moriendi presents an alternative perspective to this medico-political framing of death. Ars Moriendi suggests that ‘domination of death’ is the wrong way to approach thinking about our own mortality. Rather than framing death as a medical problem or a political question, death is presented as a moral and existential challenge that calls on us to transcend corporeal realities. Death is about coming to terms with our spiritual nature — the dimension of the human person that goes beyond mere biology — and resisting temptations to existential despair in the face of the ineluctability of death and the dissolution of the ego.

For one, it is of vital importance that people who are dying have a significant other to accompany them in their final hours of life. Our age is more lonely than any other generation in human history. A ‘significant other’ need not be conceived of as a spiritual intercessor, as per the author of Ars Moriendi. But there is a need for true presence, whereby a loved one opens themselves up to their dying person so as to prevent existential despair in the final moments of life.

But people nearing the end of life must also recognize their spiritual nature. What might we say of spirituality in our secular age? Religiosity in Western liberal democracies has declined dramatically in the past half century. Yet even many Millennials are comfortable describing themselves as ‘spiritual though not religious’. We need not, then, dismiss the idea of openness to the transcendent as an artifact of a bygone era. Even those who have had no engagement with organized religion may be interested to see a chaplain, for example. At the very least, they can look to their own private experiences of the transcendent as a means to assist them to come to terms with the fact that life is ending.

Some may view spirituality at the end of life as a form of escapism. But we would do well to recall Wittgenstein’s dictum: “If we take eternity to mean not infinite temporal duration but timelessness, then eternal life belongs to those who live in the present”. Far from taking us away from reality, spirituality is about connecting with the world as it is, right in front of us, right here, and right now.

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Xavier Symons is a Postdoctoral Research Fellow at the Human Flourishing Program at Harvard University. He previously worked as a bioethicist at the Australian Catholic University and The University of Notre Dame Australia. Xavier’s research interests include ethical issues at the beginning and end of life, conscientious objection, the ethics of healthcare resource allocation, and pandemic ethics. His first book, Why Conscience Matters: A Defence of Conscientious Objection in Healthcare, was published in July 2022 by Routledge. Dr Symons is the recipient of a 2020 Fulbright Future Postdoctoral Scholarship and was a scholar in residence at Georgetown University’s Kennedy Institute for Ethics from September 2021 to March 2022. He holds degrees from the University of Sydney, the University of Oxford, and the Australian Catholic University.

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The Human Flourishing Program @ Harvard University

Founded in 2016, studies and promotes human flourishing, and develops systematic approaches to the synthesis of knowledge across disciplines