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'...This, in short, is how Christian belief figures into literary fiction in our place and time: as something between a dead language and a hangover. Forgive me if I exaggerate. But if any patch of our culture can be said to be post-Christian, it is literature. Half a century after Flannery O'Connor, Walker Percy, Reynolds Price and John Updike presented themselves as novelists with what O'Connor called "Christian convictions," their would-be successors are thin on the ground. So are works of fiction about the quan­daries of Christian belief. '...Where has the novel of belief gone? The obvious answer is that it has gone where belief itself has gone. In America today Christianity is highly visible in public life but marginal or of no consequence in a great many individual lives. For the first time in our history it is possible to speak of Christianity matter-of-factly as one religion among many; for the first time it is possible to leave it out of the conversation altogether. This development places the believer on a frontier again, at the beginning of a new adventure; it means that the Christian who was born here is a stranger in a strange land no less than the Sikhs, Muslims, Hindus, Buddhists, Soviet Jews .... 'The religious encounter of the kind O'Connor described forces a person to ask how belief figures into his or her own life and how to decide just what is true in it, what is worth acting on.... When we talk about belief we talk about what is permissible - about the sex abuse scandal or school prayer or whether the church should open its basement to 12‑step everything. What about the whole story? Is it our story? Is belief believable? There the story ends - right where it ought to begin.... ' This refusal to grant belief any explanatory power shows purity and toughness on the writer's part, but it also calls to mind what my Catholic ancestors called scrupulosity, an avoidance that comes at the cost of fullness of life. That - or it may show that the

'...This, in short, is how Christian belief figures into literary fiction in our place and time: as something between a dead language and a hangover. Forgive me if I exaggerate. But if any patch of our culture can be said to be post-Christian, it is literature. Half a century after Flannery O'Connor, Walker Percy, Reynolds Price and John Updike presented themselves as novelists with what O'Connor called "Christian convictions," their would-be successors are thin on the ground. So are works of fiction about the quan­daries of Christian belief. '...Where has the novel of belief gone? The obvious answer is that it has gone where belief itself has gone. In America today Christianity is highly visible in public life but marginal or of no consequence in a great many individual lives. For the first time in our history it is possible to speak of Christianity matter-of-factly as one religion among many; for the first time it is possible to leave it out of the conversation altogether. This development places the believer on a frontier again, at the beginning of a new adventure; it means that the Christian who was born here is a stranger in a strange land no less than the Sikhs, Muslims, Hindus, Buddhists, Soviet Jews .... 'The religious encounter of the kind O'Connor described forces a person to ask how belief figures into his or her own life and how to decide just what is true in it, what is worth acting on.... When we talk about belief we talk about what is permissible - about the sex abuse scandal or school prayer or whether the church should open its basement to 12‑step everything. What about the whole story? Is it our story? Is belief believable? There the story ends - right where it ought to begin.... ' This refusal to grant belief any explanatory power shows purity and toughness on the writer's part, but it also calls to mind what my Catholic ancestors called scrupulosity, an avoidance that comes at the cost of fullness of life. That - or it may show that the

"...beyond the medical advances, Dr. DeBakey's story is emblematic of the difficulties that often accompany care at the end of life. It is a story of debates over how far to go in treating someone so old, ... and risky decisions that, while still being argued over, clearly saved Dr. DeBakey's life. It is also a story of Dr. DeBakey himself, a strong-willed pioneer who at one point was willing to die, concedes he was at times in denial about how sick he was and is now plowing into life with as much zest and verve as ever. But Dr. DeBakey's rescue almost never happened. He refused to be admitted to a hospital until late January. As his health deteriorated and he became unresponsive in the hospital in early February, his surgical partner of 40 years, Dr. George P. Noon, decided an operation was the only way to save his life. But the hospital's anesthesiologists refused to put Dr. DeBakey to sleep because such an operation had never been performed on someone his age and in his condition. Also, they said Dr. DeBakey had signed a directive that forbade surgery. As the hospital's ethics committee debated in a late-night emergency meeting on the 12th floor of Methodist Hospital, Dr. DeBakey's wife, Katrin, barged in to demand that the operation begin immediately.

The researchers found that in areas where end-of-life care costs were normally high, having an advance directive significantly lowered the cost of care. On average, end-of-life care spending was $5,585 less per person in the high-spending regions when someone had an advance directive. > Having an advance directive didn't necessarily limit the initiation of aggressive treatments, but seemed to lead to their earlier withdrawal. Author said this finding was particularly important because some people make the argument that having an advance directive might limit all of the care you receive at the end of your life. But, this finding shows that while treatments are often started, for "patients with an advance directive, there's an earlier recognition of when treatments aren't working and when it's time to go to hospice."

'The setting is simple, austere. The workspace occupied by the desk is small. I am impressed not only by the simplicity of the furniture, but also by the objects in the room. The spirituality of Jorge Mario Bergoglio is not made of "harmonized energies," as he would call them, but of human faces: Christ, St. Francis, St. Joseph and Mary.... 'I ask Pope Francis point-blank: "Who is Jorge Mario Bergoglio?" He...replies: "I ​​do not know what might be the most fitting description.... I am a sinner. This is the most accurate definition. It is not a figure of speech, a literary genre. I am a sinner." ' "...In the history of salvation, God has saved a people. There is no full identity without belonging to a people. No one is saved alone, as an isolated individual, but God attracts us looking at the complex web of relationships that take place in the human community. God enters into this dynamic, this participation in the web of human relationships.... ' "In Buenos Aires I used to receive letters from homosexual persons who are 'socially wounded' because they tell me that they feel like the church has always condemned them. But the church does not want to do this. During the return flight from Rio de Janeiro I said that if a homosexual person is of good will and is in search of God, I am no one to judge.... Religion has the right to express its opinion in the service of the people, but God in creation has set us free: it is not possible to interfere spiritually in the life of a person.... ' "The confessional is not a torture chamber, but the place in which the Lord's mercy motivates us to do better. I also consider the situation of a woman with a failed marriage in her past and who also had an abortion. Then this woman remarries, and she is now happy and has five children. That abortion in her past weighs heavily on her conscience and she sincerely regrets it. She would like to move forward in her Christian life. What is the confessor to do? ' "We c

'The setting is simple, austere. The workspace occupied by the desk is small. I am impressed not only by the simplicity of the furniture, but also by the objects in the room. The spirituality of Jorge Mario Bergoglio is not made of "harmonized energies," as he would call them, but of human faces: Christ, St. Francis, St. Joseph and Mary.... 'I ask Pope Francis point-blank: "Who is Jorge Mario Bergoglio?" He...replies: "I ​​do not know what might be the most fitting description.... I am a sinner. This is the most accurate definition. It is not a figure of speech, a literary genre. I am a sinner." ' "...In the history of salvation, God has saved a people. There is no full identity without belonging to a people. No one is saved alone, as an isolated individual, but God attracts us looking at the complex web of relationships that take place in the human community. God enters into this dynamic, this participation in the web of human relationships.... ' "In Buenos Aires I used to receive letters from homosexual persons who are 'socially wounded' because they tell me that they feel like the church has always condemned them. But the church does not want to do this. During the return flight from Rio de Janeiro I said that if a homosexual person is of good will and is in search of God, I am no one to judge.... Religion has the right to express its opinion in the service of the people, but God in creation has set us free: it is not possible to interfere spiritually in the life of a person.... ' "The confessional is not a torture chamber, but the place in which the Lord's mercy motivates us to do better. I also consider the situation of a woman with a failed marriage in her past and who also had an abortion. Then this woman remarries, and she is now happy and has five children. That abortion in her past weighs heavily on her conscience and she sincerely regrets it. She would like to move forward in her Christian life. What is the confessor to do? ' "W

>'With unrealistic expectations of our ability to prolong life, with death as an unfamiliar and unnatural event, and without a realistic, tactile sense of how much a worn-out elderly patient is suffering, it's easy for patients and families to keep insisting on more tests, more medications, more procedures. >Doing something often feels better than doing nothing. Inaction feeds the sense of guilt-ridden ineptness family members already feel as they ask themselves, "Why can't I do more for this person I love so much?" >...At a certain stage of life, aggressive medical treatment can become sanctioned torture. When a case such as this comes along, nurses, physicians and therapists sometimes feel conflicted and immoral. We've committed ourselves to relieving suffering, not causing it. A retired nurse once wrote to me: "I am so glad I don't have to hurt old people any more." '

Easter is the traditional time for Christians to reaffirm their faith. I want to show that we can do this without renouncing reason. ..."Sources of the self" are the sources nurturing the values that define an individual's life. For me, there are two such sources. One is the Enlightenment, where I'm particularly inspired by Voltaire, Hume and the founders of the American republic. The other is the Catholic Church, in which I was baptized..., ...educated for 8 years ... by Ursuline nuns and for 12 more years by Jesuits. For me to deny either of these sources would be to deny something central to my moral being. ...The Catholic philosophical and theological tradition is a fruitful context for pursuing fundamental truth, but only if it is combined with the best available secular thought. ...These three convictions do not include the belief that the specific teachings of the Catholic Church provide the fundamental truths of human life. What I do believe is that these teachings are very helpful for understanding the human condition. Of course, I can already hear the obvious objection: "What you believe isn't Catholicism - it is a diluted concoction that might satisfy ultra-liberal Protestants or Unitarians, but is nothing like the robust tonic of orthodox Catholic doctrine. My answer is that Catholicism too has reconciled itself to the Enlightenment view of religion.

'If you met me, you'd never know I was mentally ill. In fact, I've gone through most of my adult life without anyone ever knowing - except when I've had to reveal it to a doctor. And that revelation changes everything. It wipes clean the rest of my résumé, my education, my accomplishments, reduces me to a diagnosis. I was surprised when, after one of these run-ins, my psychopharmacologist said this sort of behavior was all too common. At least 14 studies have shown that patients with a serious mental illness receive worse medical care than "normal" people. Last year the World Health Organization called the stigma and discrimination endured by people with mental health conditions "a hidden human rights emergency." If you met me, you'd never know I was mentally ill. In fact, I've gone through most of my adult life without anyone ever knowing - except when I've had to reveal it to a doctor. And that revelation changes everything. It wipes clean the rest of my résumé, my education, my accomplishments, reduces me to a diagnosis. I was surprised when, after one of these run-ins, my psychopharmacologist said this sort of behavior was all too common. At least 14 studies have shown that patients with a serious mental illness receive worse medical care than "normal" people. Last year the World Health Organization called the stigma and discrimination endured by people with mental health conditions "a hidden human rights emergency." I never knew it until I started poking around, but this particular kind of discriminatory doctoring has a name. It's called "diagnostic overshadowing." According to a review of studies done by the Institute of Psychiatry at King's College, London, it happens a lot. As a result, people with a serious mental illness - including bipolar disorder, major depression, schizophrenia and schizoaffective disorder - end up with wrong diagnoses and are under-treated. That is a problem, because if yo

'That undercurrent of violence I felt when I was 6 was there again, present in the easy devaluation of the word "nigger." I knew that it was that very history of violence - my dead great-great-grandfather's ghost and all the young black men who died at the hands of people who thought they were lesser - that was the subtext. This was why I felt so threatened, so overwhelmed, why I was often silenced when people said these things to me. [Violence] in fact exerted a strong undertow in the present. That it could take my great-great-grandfather, but also take young men like Oscar Grant III, shot to death by a transit officer in Oakland in 2009, like Trayvon Martin, like my only brother, killed by a hit-and-run drunken driver who was charged with leaving the scene of an accident but never with the crime of my brother's death. That it could assert they were less in life and deny them justice after death as well. That living in a country where one group of people owned another group of people for some 250 years yielded a culture where one life was worth less than another. Again and again. Then and now.... There is power in naming racism for what it is, in shining a bright light on it, brighter than any torch or flashlight. A thing as simple as naming it allows us to root it out of the darkness and hushed conversation where it likes to breed like roaches. It makes us acknowledge it. Confront it. And in confronting it, we rob it of some of its dark pull. Its senseless, cold drag. When we speak, we assert our human dignity. That is the worth of a word.'

From: Keating N, et al "Physician factors associated with discussions about end-of-life care" Cancer 2010; DOI: 10.1002/cncr.24761.

Pro's & con's on assisted suicide, & adequate support for patients & caregivers at end-of-life - initiated by letter by Janice Lynch Schuster, at Ctr for Elder Care & Advanced Illness, Altarum Institute

UPDATE ON: 'In 1994, The New York Times reported on how those members, or "partners," as they called themselves, had settled into their first year of life as a community ("Retirement? For 11 Friends, It's Off to Camp"). It was one of a number of such experiments, known as cohousing communities, that were springing up around the country at the time, based on a Danish model developed in the 1960s.... How did the experiment turn out? On the 20th anniversary, the consensus was generally positive. As Helen Papke, 84, observed, it has been a lesson in patience. "When it's good, it's so good," she said. "And when it's bad, it's so bad, the angst and argument we have with each other. But we have a conviction to work it out - and we will." Dick Browning, 78, whose wife, Louise, died in 2007, was more effusive. "I love it," he said. "I love the community." Of the original 11 members, seven are still here, although apart from Ms. Browning, no one has died. (One couple and one woman left for personal reasons.) The community has taken on new members, so there are now 13 altogether...,'

UPDATE ON: 'In 1994, The New York Times reported on how those members, or "partners," as they called themselves, had settled into their first year of life as a community ("Retirement? For 11 Friends, It's Off to Camp"). It was one of a number of such experiments, known as cohousing communities, that were springing up around the country at the time, based on a Danish model developed in the 1960s.... How did the experiment turn out? On the 20th anniversary, the consensus was generally positive. As Helen Papke, 84, observed, it has been a lesson in patience. "When it's good, it's so good," she said. "And when it's bad, it's so bad, the angst and argument we have with each other. But we have a conviction to work it out - and we will." Dick Browning, 78, whose wife, Louise, died in 2007, was more effusive. "I love it," he said. "I love the community." Of the original 11 members, seven are still here, although apart from Ms. Browning, no one has died. (One couple and one woman left for personal reasons.) The community has taken on new members, so there are now 13 altogether...,'

NYH palliativist fights for her own life to the end

Discussion of palliative sedation at end of life (Franklin Hospital Hospice Unit, NSLIJHealth System & Hospice Care Network of L.I.)

'Haidt's lone hero among the great philosophers - David Hume - points out, there is a logical gap between what is done (descriptive ethics) and what ought to be done (normative ethics). Haidt acknowledges that his concern as a psychologist is overwhelmingly descriptive. But he says almost nothing about how to connect his work with the compelling normative questions of human life. Engaging with the extensive philosophical discussions of Hume's distinction between "is" and "ought" could help fill this major gap in Haidt's account of ethics.'

'When I began to spend time, 10 years ago, at an evangelical church in Chicago..., I soon came to realize that one of the most important features of these churches is that they offer a powerful way to deal with anxiety and distress, not because of what people believe but because of what they do when they pray.... 'Rev. Rick Warren's "The Purpose Driven Life," one of the best-selling books of all time, teaches you to identify your self-critical, self-demeaning thoughts, to interrupt them and recognize them as mistaken, and to replace them with different thoughts.... 'In my own research, the more people affirmed, "I feel God's love for me, directly," the less stressed and lonely they were and the fewer psychiatric symptoms they reported.'

Quality of living & dying

"It's a Wonderful Life," 2011 version - in Cattaraugus, NY: state's smallest bank treats individuals as known persons, not subjects of risk-algorithms

"...In tests of the real-life niche travel agencies in New York City and elsewhere that serve specific immigrant communities, pitched against the popular Web sites - like Expedia, Kayak, Vayama - nearly every time, travel agents bested the Internet big boys on both price (the objective part of the test) and service (what you might call the essay question). In other words, the agents suggested alternate routes, gave advice on visas and just generally acted, well, more human than their computer counterparts."