Sermon Archive
Like souls in cages
Sermon preached by Kenneth Boyd at Evensong on 6 May 2006
2 Kings 2:1-15 ; Hebrews 4:14-5:10
A friend who is a hospital consultant was telling me last week about his son. The 17 year old wants to be a doctor, and has been getting work experience in a nursing home. Some of the old people he met there, the boy told his father, were "like souls in cages. Like, you can see they're there, but they look like they don't want to be.”
'Like souls in cages'. And that, the doctor remarked, too often was the case in hospitals today: 'we fail the souls and build the cages'. 'In the rush and glamour of acute care, in the busy system that is designed to cure and doesn't like to lose', too many people who ought to have been allowed to die in peace, are kept alive by medical technology, to linger on for months or years, 'like souls in cages'.
That isn't always the case, of course. One of the things that doctor never fails to impress on his juniors is how to discern when their task is no longer to cure the sick, but to comfort the dying. And many good doctors and nurses nowadays, he says, have learned that. When his own mother recently suffered a massive stroke, she went in one day from being a fit and active 90 year old to being 'like a soul in a cage'. But the hospital to which she was taken, respected her previously expressed wishes not to be kept alive in such a condition, cared lovingly for her, and allowed her to die peacefully. They did not cage her soul. What came to mind when the doctor told me of his mother's death were the words of Psalm 124, in the old Scottish metrical version: 'Ev'n as a bird, out of the fowler's snare/ Escapes away, so is our soul set free' - and then too that marvellous vision in our first lesson tonight, of the fiery chariot swinging low, and Elijah going 'up by a whirlwind into heaven'.
A soul set free, a peaceful death in hospital or at home - that is much more common than we often give our health service credit for. We focus on the horror stories we read about in the media or hear from friends of friends: at one extreme the murderous Dr Shipman, at the other, overzealous efforts to prolong life artificially, and 'souls in cages'. What we overlook in all this are the much more everyday cases, of doctors and nurses discerning when their task is no longer to cure the sick, but to comfort the dying, and achieving just that for so many people.
What the rest of us also sometimes fail to appreciate, moreover, is just how difficult in some cases that discernment can be. Some of the 'souls in cages' are there, not because doctors have overzealously prolonged the life of someone who plainly ought to have been allowed to die. They are there because, at the time when a crucial decision had to be made, it genuinely was not clear whether a treatment would restore the patient to life and health, or leave them like a soul in a cage. In the health service today many people are trying to improve how such decisions are made - either through their teaching and example like the doctor I have mentioned, or by drawing up clearer guidelines about when resuscitation, for example, should and should not be attempted. But even with the best guidelines, the best will, and the best medical and nursing skill in the world, there will always be some times when it is not clear, until too late, which decision ought to be taken. There will always be some 'souls in cages', in other words, for whom no-one is to blame.
And that, I suspect, is one of the main reasons why many people have supported the recent, but so far unsuccessful, Parliamentary efforts to legalise euthanasia. There are good ethical arguments both for and against legalising voluntary euthanasia or assisted suicide, but I don't want to say much about them now. The arguments against include the danger that legalising euthanasia will diminish respect for human lives and human rights. But among the arguments for, not the least powerful is that there still are people whose pain or suffering even the best medical care and treatment cannot relieve, and whose world-weary bodies refuse to die, despite their soul's longing to do so. 'O! let him pass; he hates him/ That would upon the rack of this tough world/ Stretch him out longer'.
Such are the 'souls in cages'. Or are they? Here, I think, we need to be careful, to think a little more deeply. Underlying many of the ethical arguments in favour of euthanasia, is the feeling, perhaps the dread, of ourselves, or those we love, 'ending up' as a 'soul in a cage'. But over against that feeling is the observation made by some people with severe disabilities, that what seems to a fit and active 17 year old like a 'soul in a cage', may seem very different to that soul him or herself: "look deeper - see me" as the 'crabbit old woman' in the poem asks. There is too, the argument that suffering, even at the end of life, can be an occasion for spiritual growth. That argument, clearly, is insensitive and impertinent when offered by someone who is not suffering to someone who is. But in the minds and hearts of many who have suffered greatly in this world, encouragement and reassurance undoubtedly have been drawn from words like those in tonight's second lesson - about how Jesus 'learned obedience through what he suffered' - or perhaps in the words of the Scottish metrical paraphrase of the same passage 'In ev'ry pang that rends the heart,/ The Man of sorrows had a part;/ He sympathises with out grief,/ And to the suff'rer sends relief.'
But to say even that much, again, is to underline our need to be careful, to think more deeply. Not all who appear to others to be 'souls in cages' are such, and even the future encaged soul we ourselves dread, may not be that, if or when our time comes. One of the interesting things about growing older is how your perspective on age can change: growing old disgracefully can seem much less awful at sixty-six than at twenty-six. Nevertheless, what the doctor's son said, for some people really is all too true: “they're there, but … they don't want to be”; and some are suffering unbearably; and some perhaps are no longer there at all.
There are, to paraphrase T S Eliot, many 'conditions which often look alike/ Yet differ completely, flourish in the same hedgerow'. What seem like 'souls in cages' may indeed be so. But souls differ in how they themselves or others see them, and either may change with time and circumstance. That is why, I suspect, legalising euthanasia will be no cure for these intractable complexities of the human condition. Whether the law is changed, or remains as it is, there will always be difficult, agonising, decisions for individuals, for families, and for doctors and nurses, as the end of life approaches.
In these circumstances, I said earlier, doctors and nurses need to discern when their task is no longer to cure the sick but to comfort the dying. But it is not just medical people who need to learn how to discern between 'conditions which often look alike/ Yet differ completely'. If we want a really decent and human society, in which individual differences are respected and people are treated as persons, all of us need to learn such discernment. But how do we learn it?
Well, the word 'discernment', as someone reminded me only last week, has a long history in Christian spirituality. 'Discernment of spirits', according to this tradition, is a matter of 'weighing interior experiences to determine if their ultimate origins are divine'. It is a matter, in other words, of looking critically at our own thoughts and feelings, and our reactions to people and events, in the light of conscience, and of all we have learnt and can learn from the wisdom of others. Much can be learnt today from psychology and counselling for example. For Christians, wisdom comes especially from what Scripture and Tradition teach, but not exclusively from them, since in the gospels Christ himself warns us against mistaking the letter for the spirit, and encourages us to use our imagination.
Even then, of course, we can never be certain that our thoughts and feelings are those that God would have us think and feel. We must pray that they become so. But for that prayer to be sincere, we must also be prepared to listen to others, and to be self aware and self critical. What, for example, are our feelings doing, when we see other people as 'souls in cages' and think perhaps that it would be better for them to be 'put out of their misery'? How do we know, without actually listening to each individual one of these souls, how they really are feeling? Are we really motivated by their interests? Or by our own interest in not being made uncomfortable by their existence in our world, or even by their being a disturbing reminder that one day we might be in their place? Our minds have many ways of helping us deceive ourselves about our own motives. We too therefore need to learn discernment.
Discernment can be an uncomfortable task. But the great gift to us, from the great high priest of whom the letter to the Hebrews speaks, is that we need not feel too proud to let his light shine on the darkest, dankest and dreariest depths of our hearts, and freely forgive all that it uncovers there - forgive, so that we may discern more clearly how to live well, and how to love one another. None of us knows the future - or whether your soul or mine someday may be caged by disease or disability. But that at the last, our soul shall be set free, is the highest hope and deepest mystery of Christian faith. What that mystery means however, can be learned only by allowing ourselves, even now - and every day of our lives - to escape from the cages and mind-forged manacles we build for ourselves - the cages of habit and prejudice, of pride or despair. And we escape, we are set free, by forgiving and being forgiven, by exercising true discernment, and by living in the spirit of the collect we prayed on Ascension Day.
GRANT, we beseech thee, Almighty God, that like as we do believe thy only-begotten Son our Lord Jesus Christ to have ascended into the heavens; so we may also in heart and mind thither ascend, and with him continually dwell; who liveth and reigneth with thee and the Holy Ghost, one God, world without end. Amen.
Worship >> Sermons >> Sermons