Peter Saul: Let’s talk about dying

This is a quote from Dame Cicely Saunders, whom I met when I was a medical student. She founded the hospice movement. And she said, “You matter because you are, and you matter to the last moment of your life.” And I firmly believe that that’s the message that we have to carry forward.

Level Goals Themes
 Intermediate  Present Perfect Revision  Death and dying
 Upper-intermediate  Contrasting Clauses  Euthanasia
 Advanced  Ethics

We can’t control if we’ll die, but we can “occupy death,” in the words of Dr. Peter Saul. He calls on us to make clear our preferences for end of life care — and suggests two questions for starting the conversation.

Over the past 35 years Peter Saul has been intimately involved in the dying process for over 4,000 patients. He is passionate about improving the ways we die.

INTRO DISCUSSION

  • What is euthanasia? Do you think it should be legal? Why / Why not?
  • Do you think it’s a good thing to talk about the way we should die, and what decisions we need to make beforehand?
  • Would you talk about this with your family members – Parents or grandparents?

COMPREHENSION

True or False?

  1. Peter Saul supports Euthanasia because it gives people power over how they die.
  2. Organ failure and increasing frailty are becoming the most common causes of death.
  3. Saul’s professional background is in intensive care.
  4. The way that people die has not changed over the past 20, 30 or 40 years.
  5. At least one in ten people will die in intensive care.
  6. The majority of people are now dying of slow organ failure and frailty.
  7. Saul’s goal is for people to start having conversations with their friends and family about what to do when they reach the end of their lives.

VOCAB

Vocab Definition
1. Intensive care A. The state of increasing weakness and limited capacity for life.
2. Euthanasia B. The final result or conclusion.
3. Frailty C. The core part of a speech or writing used to convince somebody. The main form of words used when trying to persuade somebody to accept or buy something.
4. Longevity D. Caring for a patient without treating their illness, but simply reducing pain and suffering.
5. Pitch (noun) E. Special medical care of a dangerously sick or injured patient.
6. Outcome F. To be important.
7. Palliative care G. The painless killing of a patient who has chosen to die rather than continue suffering.
8. To matter (verb) H. Long life.

Other useful or interesting vocabulary:

  • Right (To have a right to…): A moral or legal entitlement to something.
  • To square (with somebody): To make compatible or reconcile different beliefs, to be totally honest.
  • Heyday: The period of someone or something’s greatest success.
  • To Shift: To change
  • To get caught up (in/with something): To become preoccupied or obsessed with a particular thing or area.
  • Set about: To begin, aim or intend to do something.
  • To look at (In context): To examine

GRAMMAR

Present Perfect (Revision):

Find all of the instances of the present perfect in the following paragraphs:

  • Now, as you heard in the intro, I work in intensive care, and I think I’ve kind of lived through the heyday of intensive care. It’s been a ride, man. This has been fantastic.
  • And we have some wizard technology which I think has worked really well, and over the course of the time I’ve worked in intensive care, the death rate for males in Australia has halved, and intensive care has had something to do with that.

Clauses of Contrast

To contrast: For two things to differ to significant degree

The most common and easily understood word we use to contrast clauses is BUT. Some examples:

  • It was raining, but we went to the park anyway.
  • I hate driving, but I always drive to work.
  • I am great at basketball, but terrible at soccer.

We can however, use many other words to express contrast:

Although

  • Although it was raining, we went to the park.
  • Although I hate driving, I always drive to work.
  • Although I am great at basketball, I am terrible at soccer

Even though

  • Even though it was raining, we went to the park.
  • I always drive to work, even though I hate driving.
  • Even though I am great at basketball, I am terrible at soccer.

However

  • It was raining, however, we went to the park.
  • I hate driving. However, I always drive to work.
  • I am terrible at soccer, however, great at basketball.

Despite (the fact that) / (x)

  • Despite the fact that it was raining, we went to the park.
  • Despite the rain, we went to the park.
  • Despite the fact that I hate driving, I always drive to work.
  • Despite my hatred of driving, I always drive to work.
  • Despite the fact that I’m great at basketball, I’m terrible at soccer.
  • Despite being great at basketball, I’m terrible at soccer.

PRACTICE

Fill the gaps with the correct contrasting conjunction – Although, Even though, However or Despite.

  1. ___________ euthanasia isn’t legal, we should still think about how people want to die.
  2. The prolonging of life is important, __________, it can be a difficult subject to talk about.
  3. Organ failure is a common cause of death, __________, frailty is becoming much more so.
  4. ___________ euthanasia being legal in Oregon, only a very small percentage of people choose to die.
  5. __________ it is culturally complex, talking about death helps patients.
  6. __________ the fact that talking about death is uncomfortable, it is necessary for everybody.
  7. __________ euthanasia is illegal, people still kill themselves by choice at a late stage of life.

DISCUSSION

On Death

  • Is it good to talk about the way we want to die? Would you have that conversation with your family members?
  • Do you think a program like the one Saul and his colleagues implemented in Australia, promoting conversations about death and dying, would be good for people in your country? Why / Why not?
  • Are there any ways in which it would be bad if we spoke more about the end of life and how to handle palliative care?
  • What would be your preferences about how you should die? Is it possible to answer that question without being in that situation?
  • Is it right to prolong life through intensive care? When might it be wrong?

On Euthanasia:

  • Has your opinion on euthanasia changed after hearing Saul’s talk? How so? Why / Why not?
  • If somebody has diminished mental capacity, how do you decide if they are capable of making choices regarding their death?
  • What legal or moral problems can you think of surrounding euthanasia?
  • What is the general attitude toward euthanasia in your country?
  • Of the four ways to die that Saul presents, which would you choose if you could – Sudden death, terminal illness, organ failure or increasing frailty? Why?
  • Do you think that euthanasia obligates people to die in any way? For example, if they think they are a burden on their families.
  • Would you choose euthanasia for yourself? Is it possible to know?

DEBATE

  • Having conversations about death with the elderly and frail causes unnecessary stress for them and their families. We should forget about encouraging people to do this and simply allow people to deal with death as they choose.
  • Euthanasia is morally disgusting. Nobody should be afforded the right to die – life is sacred should always be preserved, whatever the cost.
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