How Doctors Die: An ICU Nurse Responds

Note by Michael Dowd: A week ago a colleague sent me a link to an obscure blog that had “gone viral”:

“How Doctors Die — It’s Not Like the Rest of Us, But It Should Be"

Tremendously moved, I decided to do my part in spreading this sobering news and vital perspective. One of those who received my email was a young nurse, newly certified for working in the Intensive Care Unit. Below is her response (slightly modified for confidentiality).

Her story brought me to tears of joy and gratitude when I first read it. May there be ever more nurses with the training, the courage, and above all the heart exemplified by this unheralded young hero.
_____

Response by a young “Intensive Care Unit (ICU)” nurse:

Thank you so much for this timely article. Only two months ago I participated in an "End of Life and Palliative Care in the ICU" class, where I was genuinely moved/tormented by the suffering my fellow nurses and I are surrounded with in the ICU.

A peaceful, gentle death is so valuable — and so rare.

I recently cared for a young adult cancer patient at the end of her life.  She came to the ICU after having a bone marrow transplant to deal with the "pre-leukemia" she had developed, owing to an aggressive chemo regimen initiated several years earlier for her breast cancer.

By now, her whole body had deteriorated to such an extent that she required a mask that forced air into her lungs in order to oxygenate.  She spent two weeks in our hospital’s ICU, with her lungs progressively worsening.

All the nurses knew she was not going to leave our unit. But her oncologist kept telling her to “fight it out!”

Finally, and this was on my shift, with her parents at her side, “Gloria” (the name I'll use) finally said that she just wanted the pain to go away.

Suddenly, everything changed.

I had just brought into her room her evening meds — literally thousands of dollars worth of antibiotics and anti-rejection medications.  None of it mattered anymore.

I took down all the unnecessary tubing, started a morphine drip and administered Glycopyrrolate (which dries secretions and softens the "death rattle").

This felt massive to me. I remember this mix of emotions: sadness, relief, and an overwhelming sense that I was a part of something huge.  I still cannot wrap my head around it.

I was able to help transition one profoundly suffering human being from a regimen of “Come on! Power through! Endure, endure, endure!” to, “It’s okay, Gloria. You fought so, so hard. Now close your eyes, let your pain fade, and rest.”

It was beautiful.

Gloria died the following day — not on my shift, but I felt so happy that I had been able to share the transition with her and her parents.

To think of everything we had put this woman through in hopes of an inaccessible cure is just ... sickening.

Medicine has gotten to the point where we've gone as far and as invasive as we can go. I wish people — both we professionals and the public at large — would begin to prioritize a dignified death above all.

Family members need to know that there is far more beauty in spending quality time (rather than simply a quantity of time in the hospital) with their unalterably disabled and ultimately incurable loved ones.

Sadly, when family members must make medical decisions, too often those decisions are influenced by a subconscious need to palliate our own emotional suffering. As well, an irrational fear that we will otherwise be guilty (or at least will feel guilty) spurs good people to say “yes” to absolutely every intervention that forestalls death.

Though I wish everyone could die at home surrounded by love and comfort, I know it is the nature of those battling cancer to often push themselves far past their ability to survive the journey home.

It is my duty to honor this incredible fight and allow them to pass peacefully, without pain — and to let them know that accepting death is the greatest victory.  

~ by an ICU nurse, posted by...

Evolutionary Parenting: Thoughts About Holidays

by Jon Cleland Host

Though I mentioned some resources for Evolutionary Parenting in my previous blog post, I never meant to suggest that it is easy – it’s not (heck, good parenting of any kind isn’t easy).  Like so much in life, however, that extra intentional effort is very rewarding.

Right now, at the beginning of December, many of us are indeed spending effort – preparing for the holidays.  But which holidays?  From the many available, nearly all of us are celebrating the holiday our parents taught us, perhaps including minor tweaks from our lives or our spouses.  That’s not a surprise, given that holidays are one of the most common ways that values are passed on to the next generation, answering our human need for both celebration and meaning.

Why “No Holidays” Is Not an Option

Our involvement in holidays, in terms of both time and money spent on the kids, is especially clear for many of us at this time of year – showing that we care about them.  After all, it is where we spend our time and money that shows what we really care about.  Children know this.  They see us with more unvarnished honesty than we may realize, constantly learning from what we actually do, nearly heedless of what we say.  Children see through hypocrisy like a picture window, especially as they get older.

So, what then are we teaching them with our chosen holidays, which speak to our children more loudly than anything we tell them?   What is all our holiday effort working to build?  Because honesty is one of the most important aspects of good parenting, my wife and I carefully chose which holidays to celebrate, and how to celebrate them.  Like a culture’s origin story, a culture’s holidays also must be both meaningful and real (or believable).  Real, for a holiday, includes being both fun and factual.  Holidays that aren’t fun backfire, leading to resentment that only teaches avoidance or antipathy towards the parents as well as whatever idea is otherwise intended.  Conversely, a holiday that is fun, but has no basis in reality or fails to teach good values, is little more than rank consumerism, teaching children greed and gluttony.  Does that sound like some holidays we have in America today?  Is it a surprise that so many Americans have grown up to be greedy, gluttonous, and empty of deep values, having learned exactly what they were taught?

What can be done?  Jettisoning all traditional holidays without replacing them is like having holidays that aren’t fun – especially when all your children’s friends are having a blast with those traditional holidays.  Do we have any choice other than empty holidays based on consumerism and superstition?

The answer is yes.  We do have another option, one which draws on the love, creativity, and effectiveness present in today’s parents – we can craft holidays that are meaningful, real and fun.  How that’s done will vary from family to family, and so what follows are just the solutions that Heather and I have found to work well for our family.  These may be a useful starting point, but ultimately it is up to each parent to find their family’s solution themselves.  For many, some adjustments to their old holidays may be all that is needed, and any holiday solution must be sustainable in today’s modern culture.  Too radical a departure will become an effort to maintain over the years, especially if they are celebrated on significantly different dates from traditional holidays, and are thus more likely to be abandoned over time.  The rest of this already long blog post describes our family celebration.

The Cleland-Host Family Approach to Holidays Around the Winter Solstice

Obviously, our whole year of family holidays is beyond the scope of a blog post, so this will cover only the Winter Solstice, which is December 22nd this year.  In this darkest time of the year, the returning light and the hope that light brings has been enough to make this time sacred for literally millions of your Ancestors for thousands of years.   Our modern understanding of the Universe gives us many other ideas to celebrate as well, and we have chosen stars (our Sun and other stars) as a central theme of our family Winter Solstice celebration.  Included in that theme are also supernovae, the stardust that makes our world (and us), the winter season, and connection to all humans that comes from realizing that ancient people on all continents celebrated the Winter Solstice millennia ago.  The Winter Solstice is, after all, the reason for the season – both meteorologically as well as culturally!

Holidays (and family cultures) must also have practices.  Our traditions for the Winter Solstice are similar in many ways to practices our kids see their friends doing.  They include a decorated Solstice Tree (with a star on top). Solstice lights are strung indoors and out (we point out to the kids that the different colors of the lights are like the different colors of the stars, and talk about star colors and types). Stockings are hung, as well as decorations with stars, evergreens, and snow.  We open a door in an “Advent” calendar every day, counting down the days to Solstice with small surprises, and tell the stories of stardust and of Kabibonokka (the north wind) over eggnog and cookies made in the shapes of stars, snowflakes, and evergreens.  See here for related resources.

This all of course culminates on the Winter Solstice itself.  After weeks of anticipation, we eat a decorated ice cream Yule Log on the night before Solstice, pointing out that our bodies’ metabolism will be burning that Yule log all night.  The next morning, the kids usually wake up before sunrise, and are allowed to go through their (now filled) Solstice stockings.  Soon, we gather up the kids in the dark blue of morning, trekking out to see the Sun return, victorious after its long decline.  The rising Sun is greeted with songs and poems, and then we take some time as a family to enjoy wherever we are — which is often the Lake Huron shoreline, as our home is in Midland, Michigan.

The kids are jumping with excitement by the time we return home, reminded that love from the Universe can make wonderful things happen.  They rush out to our family’s sacred space, a stone circle in our wooded backyard, to find gifts for all.  The gifts are brought into the house and opened one at a time, to start a sacred day with no work, instead having a party, visits with extended family, or other family time.  If asked, we truthfully answer questions about how the gifts got out there, if those questions are supported by evidence and good reason.  We never lie to the children, and they know that.  When a child uses their own reason to discover that we put the gifts there, we point out that what we told them first was true, because we parents are part of the Universe, and that they are not allowed to tell their siblings, who must also figure it out themselves.  So far, only our oldest child has figured it out, though his brother came very close last year, and I expect him to figure it out easily any day now.

How ever you choose to celebrate the season, our family extends the warmest wishes to you.

Happy Holidays!

~ Jon Cleland Host

Evolutionary Parenting: An Introduction - Jon Host

by Jon Cleland Host

One of the most important parts of an evolutionary worldview is a commitment to future generations. Why? Because an evolutionary worldview includes the realization that we are all a part of the grand saga of life, the Great Story of the Universe, the diary of that irrepressible pulse of life, surging in us all.

This realization shows us the immensity of the story behind us, and therefore, the immensity of the story ahead of us. But what will that story be? We see from the past that it could contain a lot of horror, and a lot of good, and everything in between. To know that our great grandchildren (or those of our relatives) for seven generations and more will live in the world we give them makes this much more than idle speculation, transforming it into a drive to give back to the Universe and to life itself by doing what we can to help.

For those of us who are parents, this means working to raise our children as well as possible, giving them the tools that will help the future of all, and doing so with joy. Our children are humans, and understanding the needs of (and threats to) human children requires an understanding of the evolutionary history that made them. This is why Evolutionary Parenting includes both the connection to our evolutionary past, as well as the sense of purpose supplied by our awareness of future generations.

Talking about all those evolutionary needs and threats would take many books, so for this blog post, I’ll start with one small part of a family culture, and that is our human need for a meaningful, trusted story of how we got here. For dozens of millennia, humans in cultures around the globe grew with stories of how we got here that gave their lives meaning, richness and a sense of roots, so it’s no surprise that we humans have evolved to need such stories when we are children. To fulfill this need, a story must be meaningful – in that we must attach meaning to it, and not see it as irrelevant or “just dry facts”. It must also be believable – in that it needs to be supported by the facts as well as we know them. In other words, it has to be real. If the story fails either of these requirements, then children (and adults) cannot get all of the benefits we need from it as humans.

We are living in a time when nearly all of us are denying our children (and ourselves!) this basic human requirement. Scientific discoveries have demonstrated beyond a shadow of a doubt that the old creation myths, like the Native American story of Nanabozho or the Genesis story, aren’t literally true (they might still be meaningful, but are no longer believable), while the story that is believable, the evidence-based Universe Story, is rarely taught in a meaningful, inspiring way. Only a story that is both meaningful AND believable can fulfill this basic human need.

Others are recognizing this cultural loss as well. As Nancy Ellen Abrams states:

Without a meaningful, believable story that explains the world we actually live in, people have no idea how to think about the big picture. And without a big picture, we are very small people.

And over a half century ago, Maria Montessori told us that:

…by offering the child the story of the universe, we give him something a thousand times more infinite and mysterious to reconstruct with his imagination, a drama no fable can reveal."

I’ve lost count of the times when, in teaching creation myths to children, they seem uncaring, especially after asking, repeatedly “but is that what really happened?”. They are already too smart to care much for stories that are known to be false. Yet, it still took me a while to realize how much children want the honest truth. Seeing myself and other adults take a long time enthusiastically embrace the Universe Story drives home the fact that we have learned our culture all too well. This is why it takes time and commitment to raise our children with the meaningful and believable history that they desperately need. Even after only a few years of doing so, I’ve already started to see the wonder and joy in my children at having a meaningful and believable origin story – a coherent, empowering cosmology.

We can give them the meaningful and believable story that they need. To do so, we only need to realize how deeply meaningful and enriching the factual Story of the Universe, as discovered by science, truly is. We only need to allow its meaning to shine through – and a moment’s reflection shows how wonderful it really is. That wonder and joy of finally reconnecting to the Universe, the same feeling our Ancestors for millennia felt, is within our grasp again. It changed my life, and others as well. Some of our stories can be read here.

Luckily, none of us have to reinvent the wheel and try to do this from scratch. There are resources available online here. For most of us, we’ll be learning at the same time, with the whole family traveling much of the path together. I hope to discuss some of the ways we’ve found to work well in our family in future blog posts.

Evolutionary Parenting, today, is uncommon at best. But I suspect that in the future it will be as commonplace as teaching children to read and write. From seeing its effect on my life and the lives of others, I think it is just as important as even those basic skills, especially for living in the chaotic world our children will face.

~ Jon Cleland Host

ALSO SEE:

• TheGreatStory.org
• What Is The Great Story?
• Evolutionary Curricula for Children and Youth
• Stories of Awakening

R.I.P Lynn Margulis 1938-2011

Famed biologist Lynn Margulis died on November 22 at the age of 73. Lynn was one of the most creative scientists of our time. She was always pushing the edge of orthodoxy and sometimes she was right in a big way (i.e., the evolution of eukaryotes via endosymbiosis).

It would be difficult to overstate the positive impact of Lynn's work on our understanding of life, but also on my life personally, and Connie's too.

In 1989 I became the first (and only) student to be allowed to audit Lynn's "Environmental Evolution" course at the University of Massachusetts in Amherst. This proved to be a significant turning point in my life.

For the final exam, I was asked to publicly present the essence of my mentor Thomas Berry's work in just five minutes. This was one of the most empowering assignments I was ever given, and it ultimately led me to devote my life to teaching and preaching "The Great Story."

My wife Connie, too, was blessed by Lynn's generosity of spirit and mentoring support. Lynn played an instrumental role in helping Connie get her first scientific paper published in 1990, in Biosystems: "Open systems living in a closed biosphere: a new paradox for the Gaia debate". She also helped Connie get her first two books published by MIT Press, From Gaia to Selfish Genes: Selected Readings in the Life Sciences, and Evolution Extended: Biological Debates on the Meaning of Life.

Thank you, Lynn. We love you. Transiting from life to death, you have now become a cherished memetic ancestor.

Here are a few reflections on Lynn's life and legacy worth reading...

• John Brockman, Edge: "Lynn Margulis 1938-2011 'Gaia is a Tough Bitch'"

• John Hogan, Scientific American: "R.I.P. Lynn Margulis, Biological Rebel"  

• National Center for Science Education: "Lynn Margulis dies"  

• MassLive: "University of Massachusetts community reacts to death of renowned scientist and professor Lynn Marguis"

Terence McKenna Denounces Relativism and New Age Woo

Here's a powerful short YouTube clip of Terence McKenna goring the ox of postmodern relativism and non-evidential New Age woo in a clear, humorous, mild mannered, and supremely effective way. It just doesn't get any better! Thanks to PZ Myers.

A Cure for Collective Insanity?

A review of Richard Dawkins and Dave McKean's The Magic of Reality

by Michael Dowd

Richard Dawkins and Dave McKean have made my holiday shopping this year easy. Indeed, if I could pick but one book as required reading for every adolescent and adult in the world, it would be The Magic of Reality: How We Know What’s Really True.

Why am I so evangelistic about this book? Because it expands and deepens the powerful open letter that Richard wrote in the mid-1990s to his (at the time) ten-year-old daughter Juliet, “Good and Bad Reasons for Believing.” Now, just about anyone on the cusp of puberty and beyond can learn about their deep ancestry, why there are so many animals, what causes earthquakes, what powers the sun and the stars, why rainstorms sometimes produce rainbows, and even “why bad things happen.” Who can read this book and fail to see science as one of humanity’s shining achievements!

Early in chapter 1, which is titled “What Is Reality? What Is Magic?,” Dawkins lays out in a few simple paragraphs a key distinction: “Magic is a slippery word: It is commonly used in three different ways… I’ll call the first one ‘supernatural magic,’ the second one ‘stage magic,’ and the third one (which is my favorite meaning, and the one I intend in my title) ‘poetic magic’.”

Crucially, perhaps because youth are his intended audience, Dawkins maintains a tone throughout that is in no way derisive of anyone’s mythic story — including the mythic story that has been deployed for far too long in Western culture to prevent school children from learning that all creatures are their cousins and that it is a fact of chemistry that they are made of star stuff.

I do believe that, if read far and wide, this book could go a long way toward curing our species of its current collective insanity. Consider this recent statement by my fellow religious naturalist and noted philosopher of religion, Loyal Rue:

"The most profound insight in the history of humankind is that we should seek to live in accord with reality. Indeed, living in harmony with reality may be accepted as a formal definition of wisdom. If we live at odds with reality (foolishly), then we will be doomed. But if we live in proper relationship with reality (wisely), we shall be saved. Humans everywhere, and at all times, have had at least a tacit understanding of this fundamental principle. What we are less in agreement about is how we should think about reality and what we should do to bring ourselves into harmony with it.”

The Magic of Reality is a stunning example of our best collective intelligence about the nature of reality and how we’ve come to know (rather than merely believe) that science provides a more accurate map of “what’s real” and “what’s important” (or, how things are and which things matter) than ancient mythic maps could hope to achieve. I would argue that nothing is more necessary at this time in history than for people of all ages, backgrounds, and beliefs to grasp the importance of distinguishing mythic and meaningful stories of reality from the measurable and meaningful truth of reality.

After all, isn’t the ability to distinguish one’s inner, subjective world from the outer, objective world pretty much the defining mark of sanity? When a person cannot consistently do this, we say that he or she has become a danger to self and others. When a large and media savvy segment of an entire culture insists on selectively using (and selectively ignoring) the discoveries of science, the danger is vastly compounded.

Clearly and compellingly helping readers draw a distinction between myth and reality (while valuing both) is what The Magic of Reality does so brilliantly—and beautifully! Richard Dawkins’ steady prose and helpful metaphors combine with Dave McKean’s stunning illustrations to make this volume a feast for head and heart.

As I’ve written and spoken about many times during the past two years (for example, see my “Thank God for the New Atheists” sermon that was simultaneously published in Skeptic magazine and Australasian Science), I consider Richard Dawkins and many of his New Atheist colleagues to be modern-day prophets. Traditionally, prophets were not so much foreseers or foretellers. They were men and women who spoke boldly and unflinchingly on behalf of reality. Their message (couched in religious terms, of course) was essentially this: “Here’s what’s real, folks—and here’s what’s emerging. We need to get right with reality, or perish.”

In the same way that the writings of Martin Luther and John Calvin helped spark the Protestant Reformation five centuries ago, I see Richard Dawkins and David McKean’s book helping 21st century religious folk to break free of idolatry of the written word and thereby spark an Evidential Reformation.

It is on this point that I depart from Dawkins in a major way. I truly do wish for reform of all the world’s religious heritages—not annihilation. And I wish for reform not just because reform is a more practical and realistic approach for smoothing out the harsh edges of literalistic religious zealotry. Rather, I work for reform because religions, historically, have had an important cultural evolutionary role to play.

Following evolutionist David Sloan Wilson (author of Darwin’s Cathedral and Evolution for Everyone), I understand that religions evolved, in part, to make possible vastly larger scales of cooperation than kin selection and reciprocal altruism tend to produce on their own. Religions that could evoke individual sacrifice in the interest of shared goals were those that helped their societies defend territory, conquer the less fortunate, and adequately provision generations to come.

Thus, in a heretical way perhaps, I regard Richard Dawkins as not only a gift to our species but as the boot in the butt my own Christian tradition requires to stay relevant—and to have anything useful at all to pass on to the young people who increasingly listen, globally, more to each other than to their immediate elders.

It is now up to those very same young people to make The Magic of Reality go viral!

America's Secular Revival

The following was written by Tana Ganeva and is cross-posted from Salon AlterNet, here. For a deeper and broader look at this subject, see Davidson Loher's, "Evidence: The Decline of Christianity in America," James Haught's, "America's Religious Decline and Secular Boom," and the late Michael Spencer's "The Coming Evangelical Collapse".

America's Secular Revival

by Tana Ganeva

Five signs that, despite the GOP's efforts, religion's impact on U.S. politics will soon decline

In between bragging about the number of people they’ve killed and vilifying gay soldiers, the GOP presidential candidates have spent the primaries demonstrating how little they respect the separation of church and state. Michele Bachmann seems to think God is personally invested in her political career. Both she and Rick Perry have ties to Christian Dominionism, a theocratic philosophy that publicly calls for Christian takeover of America’s political and civil institutions. (Even Ron Paul, glorified by civil libertarians for his only two good policy stances — opposition to the Iraq and Afghanistan wars and drug prohibition — sputtered about churches when asked during a debate where he’d send a gravely ill man without health insurance.)

GOP pandering to the religious right is just one of those facts of American public life, like climate change denial and creationism in schools, that leave secular Americans lamenting the decline of the country, and of reason and logic. Organized religion’s grasp on the politics and culture of much of Europe has been waning for decades — why can’t we do that here?

But there are signs that American attitudes are changing in ways that may tame religion’s power over political life in the future.

Annie Laurie Gaylor, founder of the Freedom from Religion Foundation, tells AlterNet that she thinks what happened in Europe is (slowly) happening here. While questioning religion remains controversial — Gaylor says the group’s work on church and state issues often elicits hate mail strongly suggesting they move to, you know, Europe — atheism, skepticism and agnosticism are becoming more widely accepted.

“The statistics show there are more of us … If you’re in a room of people you can count on more to agree with non-belief or to be accepting of non-belief,” says Gaylor.

Here are five trends that give hope one day religion will reside in the realm of personal choice and private worship, far away from politics — something like what the Founders intended hundreds of years ago.

1. American religious belief is becoming more fractured

The intrusion of religion into places where it doesn’t belong, like government or public education, naturally requires high levels of organization and control — it’s not something that just happens. So it’s a good sign that even many Americans who maintain a personal religious faith are distancing themselves from heierarchical, top-down religion. Polls have repeatedly shown that even among the devout, emphatic proclamations of faith do not translate into actual churchgoing. In fact, church attendance rates hovered at around 40 percent until pollsters realized there’s a major gap between what Americans tell them about their religious habits and their actual religious habits. Tom Flynn summarizes the over-inflation of U.S. churchgoing and offers more accurate stats:

Americans may believe in a god who sees everything, but they lie about how often they go to church. Since 1939, the Gallup organization has reported that 40 percent of adults attend church weekly. (The most recent figure is 42%.) Gallup’s figure has long attracted skepticism. Were it true, some 73 million people would throng the nation’s houses of worship each week. Even the conservative Washington Times found that “hard to imagine.” New research suggests that there may be only half to two-thirds that many people in the pews.

Americans are also actively shaping their religious beliefs to fit their own values. Profiled in USA Today, religion statistics expert George Barna shares recent findings that show religion is becoming increasingly personal. Believers might drift from faith to faith until they find one that works for them, or cobble together a belief system drawn from many religious traditions. The U.S. is becoming a place of “310 million people with 310 million religions,” Barna is quoted as saying.

2. Non-belief — and acceptance of non-belief — on the rise

Last month was the first time atheists were knocked from the top of America’s most hated list, an honor that now belongs to the Tea Party. While this development may have more to do with the fact that the mainstream media’s love affair with the Tea Party is not shared by most Americans, it also dovetails with increased visibility and acceptance of atheism.

Gaylor tells AlterNet that the FFRF’s membership has never been bigger, and her observation conforms to larger trends. In a 2008 study by Connecticut’s Trinity college, 15 percent of Americans polled as “nones,” a group composed of vehement atheists, agnostics or people without religious affiliation. In 1990s, only 8.1 percent of the U.S. population could be categorized in this way, according to the report.

In an interview on NPR, Blair Scott, founder of the North Alabama Free Thought Association, says he’s noticed people are becoming more and more open-minded about non-belief: “I mean, I’ve been the victim of discrimination and harassment. They are very real, and they are legitimate concerns that people have. But what we’ve seen recently is an increase in the general public’s, maybe not acceptance, but more curiosity of what atheism is and is not.”

Scott also points out that the controversial writing of the New Atheists like Richard Dawkins regularly makes it onto the New York Times bestseller list, which in turn helps popularize atheist arguments and philosophies, even in unexpected places:

I mean, I expect an atheist group in New York, L.A., San Francisco, Seattle, etc. But where we’re seeing them pop up is little places like Jackson, Mississippi; Hattiesburg, Mississippi; Tallahassee, Florida, you know, so these little bitty mid-size and small towns, and that’s an incredible phenomenon because what that means is that these people are finally willing to say, okay, I live in a small town or a midsize city, but you know what, I know there’s others out there like me.

3. Growing numbers of young people who do not identify as religious

America is still a shockingly religious country by Western standards. But a more nuanced breakdown of religious belief tells a different story. Statistically the most devout demographics are middle-aged and older, while young Americans are increasingly likely to shun religious identification, according to professors Robert D. Putnam and David E. Campbell, writing in the L.A. Times:

As recently as 1990, all but 7 percent of Americans claimed a religious affiliation, a figure that had held constant for decades. Today, 17 percent of Americans say they have no religion, and these new “nones” are very heavily concentrated among Americans who have come of age since 1990. Between 25 percent and 30 percent of twentysomethings today say they have no religious affiliation — roughly four times higher than in any previous generation.

The writers point to a surprising culprit: the powerful religious right movement whose tight grip on American political life has steered the country in an aggressively right-wing direction for decades:

Throughout the 1990s and into the new century, the increasingly prominent association between religion and conservative politics provoked a backlash among moderates and progressives, many of whom had previously considered themselves religious. The fraction of Americans who agreed “strongly” that religious leaders should not try to influence government decisions nearly doubled from 22 percent in 1991 to 38 percent in 2008, and the fraction who insisted that religious leaders should not try to influence how people vote rose to 45 percent from 30%.

This backlash was especially forceful among youth coming of age in the 1990s and just forming their views about religion. Some of that generation, to be sure, held deeply conservative moral and political views, and they felt very comfortable in the ranks of increasingly conservative churchgoers. But a majority of the Millennial generation was liberal on most social issues, and above all, on homosexuality. The fraction of twentysomethings who said that homosexual relations were “always” or “almost always” wrong plummeted from about 75 percent in 1990 to about 40 percent in 2008. (Ironically, in polling, Millennials are actually more uneasy about abortion than their parents.)

4. Hate group that exploited religion to bash gays hemorrhaging funds

As Americans increasingly reject the politics of hate, the right-wing groups that thrive on it are facing tough times.

While many practicing Christians live their faith without trying to impose their values on others, the aggressive Christian extremism of organizations like Focus on the Family has always been charged by the demonization of people who are not like them.

Unfortunately for FOTF, many Americans just don’t hate gay people enough to keep them afloat. In 2008, FOTF had to cut its staff by 18 percent. Last week, FOTF had to do another round of cuts, again citing a drop in donations (though it claims the lower funding is a result of tough economic times). On the issue of gay rights, Focus on the Family CEO Jim Daly said:

“We’re losing on that one, especially among the 20- and 30-somethings: 65 to 70 percent of them favor same-sex marriage,” Daly said in the interview. “I don’t know if that’s going to change with a little more age—demographers would say probably not. We’ve probably lost that.”

It’s important to note that the religious right is still exceptionally powerful, as evidenced by the prominent role right-wing Christianity still plays in American politics. It is a powerful movement with lots of followers, smart P.R. and tons of organizational muscle. But as Sarah Seltzer pointed out, “The Christian right is far from dead, but it’s good to see one of its biggest wedge issues losing its power to wedge.”

5. Getting married by friends

On a lighter note, it looks like increasing numbers of Americans are looking to jettison religion out of their marriages as well. The Washington Post reported last week that more Americans are choosing wedding ceremonies without the trappings of religion, including the clergy. Reporter Michele Boorstein finds a crew of college friends who officiate at each other’s weddings:

Their decision to forgo the more traditional route is a slightly extreme example of a once-quirky trend that is becoming more mainstream. A study last year by TheKnot.com and WeddingChannel.com showed that 31 percent of their users who married in 2010 used a family member or friend as the officiant, up from 29 percent in 2009, the first year of the survey.

Boorstein points out this trend is likely the result of young people’s drift away from traditional expressions of religious faith.

Larry Goes Clubbing

by Shane Dowd

Last weekend, I was invited to go out for drinks and dancing at one of the local watering holes. The group that I was going with was mostly women.

*Larry the Lounge Lizard starts to perk up here*

Also, I hear clubs are notoriously full of scantily clad lady folk.

*Now Larry is really paying attention*

To further complicate the issue, my girlfriend has been out of town for the past two weeks. So speaking frankly, Larry (and Shane!) have been missing her ... a lot!

What is a testosterone-filled young man supposed to do in this situation?

Science has shown that when a man’s primary partner is away, his testosterone levels elevate, as does his sperm count. Evolution would have it so, apparently, because in the ancient (maybe not so ancient) past, this was prime time for a man to possibly land an EPC. That’s code for, what biologists routinely call, “extra-pair copulation.”

Higher testosterone = think more about sex and take more risks.

Hmmm . . .

Fortunately, armed with this knowledge, I can now know what challenges to expect, and I can pre-decide how to deal with them.

I am committed to not cheating. However, I also have a deep appreciation and reverence for the power of my instincts, especially when alcohol is involved and inhibitions are thereby lowered and judgment is clouded.

So what did I do?

With Larry whispering inside my head, trying to fulfill his ancient yearnings, I decided to create a game of sorts. It would be a game to see just how impeccable I could be in my actions, and a game to honor my girlfriend. Undoubtedly also, this game would strengthen the “muscles” of my prefrontal cortex that must be trained and exercised to do the “harder thing” — harder meaning, going against our primal instincts (sorry, Larry!).

The day before Larry and I were scheduled to go clubbing, I called up a trusted friend and explained the game:

“I want to commit to only having 3 drinks and also acting in such a way that if there was a video camera on me, and my girlfriend was going to see the tape the next day, she would be proud of my behavior — and feel very honored by me.”

I also shared this game with my girlfriend — which was not at all a scary thing to do. Ever since she and I took time together to read about the basics of our evolved male and female brains (see the links below), I have been able to authentically share what most of us guys assume we just have to keep hidden: that we do notice hot women, and that our Larrys do perk up. (See my earlier post, when I introduced “Larry” as my own playful name for the lustful part of my brain that harks back to when humanity’s ancient ancestor was still a reptile.)

Actually, I didn’t just explain the game to Meredith. Once she got the gist, she and I started joking around about all the hot women that would attract Larry’s attention, but that I, trustworthy Shane, would not be flirting with.

The night was a breeze (and still a ton of fun!). I danced with my female friends, I had my three drinks, and I completely honored my girlfriend and our relationship.

Would I have been fine had I not been playing this game? Absolutely. It was never about “keeping the reins” on out-of-control habits. It was simply a way of honoring my instincts and honoring what's most important to me, which is the trust in my relationship.

If you are a man who has struggled with straying or flirting outside of your relationship — and if you are committed to faithful monogamy — I encourage you to learn about your brain’s evolutionary machinery. Then you can choose to practice honoring its deeply rooted desires, as well as your higher values and commitments.

When you can authentically love those deep drives, without succumbing to their every whim, (and your partner can too), be prepared to enjoy a “lightness of being” and playfulness that's unlike anything else!
_______________________

NOTE: Links to some of Meredith's and my favorite resources on this subject:

Sex at Dawn: The Prehistoric Origins of Modern Sexuality (How We Mate, Why We Stray, and What It Means for Modern Relationships) - Christopher Ryan and Cacilda Jetha

Strange Bedfellows: The Surprising Connection Between Sex, Evolution and Monogamy - David P. Barash and Judith Eve Lipton

You Still Don't Understand: Typical Differences Between Men and Women—and How to Resolve Them - Richard Driscoll and Nancy Ann Davis

The Female Brain and The Male Brain - Louann Brizendine

Evolutionary Psychology I: The Science of Human Nature - Allen D. MacNeill

The Evidential Reformation: Humanity Comes of Age

by Michael Dowd

“We will never achieve a just and sustainably lifegiving future on the resources of the existing religious traditions, and we can’t get there without them.” ~ Thomas Berry

The 21^st century will be seen historically as humanity’s rite of passage. We’re growing up as a species, going through the very same process we’ve all gone through as we mature. As children we’re guided by beliefs and we think the world was made for us. As adults, we’re guided by knowledge and we live our lives (at least in part) as a contribution to others and the world. Indeed, for healthy adults, self-giving is actually one of life’s greatest satisfactions. As well, most of us needed no special training or incentives to begin questioning the beliefs we were spoon-fed as children – just the usual dose of hormones and peer focus that signals adolescence.

These two transformations, from beliefs to knowledge and from self-focus to contribution, are precisely what we’re now collectively experiencing. I call this species-wide rite of passage the “Evidential Reformation,” and I believe it is destined to transform not only the science-and-religion debate and how religious traditions relate to one another, but, even more importantly, how humans relate to the larger body of life of which we are part and upon which we depend.

A Big History Perspective on Religion Through Time

Big history, also known as the epic of evolution, is our common creation narrative. It is the first origin story in the history of humanity that is globally produced, derived entirely from evidence, and will soon be taught to high school students around the world (see here, here, and the YouTube clip at the end of this post).

In our “childhood” as a species – as tribes, then villages, then chiefdoms and kingdoms, then city-states and early nations – our main source of guidance came from religious beliefs. Shared allegiance to a particular religion that bridged even ethnic and linguistic differences was a crucial factor in the rise of civilizations across the globe. Consider: our instinctual heritage as social mammals will suffice for fostering cooperation at the scale of a clan. (Biologists call these instinctive forms of cooperation kin selection and reciprocal altruism.) Mutually advantageous trade then facilitated greater circles of cooperation. But for 10,000 or more human beings to be induced to cooperate: for that, you need religion – a singular, shared, unquestioned religion, and probably one that doles out harsh consequences (including ostracism) for apostates.

A multitude of religions arose independently of course, because in any bioregion where fierce competition for territory or resources arose, there would have been a survival advantage to groups that could forge cross-clan alliances for mutual defense. As well, there are two functional issues that all cultures need to address: what’s real and what’s important. (In a six-minute YouTube video based on his book, Religion Is Not About God, philosopher of religion Loyal Rue refers to these two functions as “how things are” and “which things matter.”) These two functional issues will be answered differently based upon where and when you live and upon the happenstance of interpretive imagination of one’s ancestors. Each “wisdom tradition” thus reflects regional collective intelligence encoded mythically. That is, the regional collective intelligence is encoded in pre-scientific language that reflects a people’s daytime and nighttime experience. (See here for a discussion of “Day and Night Language,” which was a central concept in my book, Thank God for Evolution.)

In our “adolescence” as a species (which was a threshold crossed as the modern era swept the globe), we began to question the beliefs, interpretations, and meanings we had inherited. The birth of this new form of collective intelligence, global collective intelligence, occurred when access to powerful new technologies (beginning with the telescope) ramped up our ability to discern how things are. We then faced the frightening truth that ancient understandings were not, in fact, the best maps of what is real. This challenging process is still facing much of the world, as traditional religious beliefs are increasingly found to be obsolete and simply no longer credible when interpreted literally.

Some individuals thrilled to the prospect of participating in this threshold event: of valuing measurable observation, rationality, and collectively encouraged skepticism and testing as the preferred means for discerning what’s real and what’s important. In the 19^th century these “natural philosophers” became known as “scientists.”

The two institutions responsible for ensuring that the self-interest of individuals and groups are aligned – namely, governance and religion – were impacted differently by the rise of modern science. Democratic forms of governance were the first to embrace evidence as authoritative. Religions are only now beginning to catch up and to not only experience the terror but also taste the thrill of what the Evidential Reformation offers.

Like any rite of passage, once one voluntarily steps through the threshold there is no integrous and healthy way of going back. So of course there are shrill voices of protest and deep institutional inertia.

But ultimately, this shift will happen. One by one, segment by segment, the great religions of the world will pass through the threshold – else they will wither and the new generations will leave them entirely behind.

“Idolatry of the Written Word” as Today’s Greatest Impediment

What the Evidential Reformation offers for religion is centrally this: Science reveals “God’s word” for humanity today – that is, what’s real and what’s important, or how things are and which things matter – far more accurately than the Bible or Qur’an could ever hope to. And Moses, Jesus, the Apostle Paul, and the Prophet Mohammad would surely be among the first to applaud this trend were they alive today.

Yet, until faith leaders become a whole lot bolder in proclaiming to their flocks the goodness and necessity of this shift, religious people will remain blind and deaf to what God (Reality personified) is revealing today through scientific, historic, and cross-cultural evidence. And that means that God/Reality will continue using the New Atheists to mock unchanging religious beliefs and those who espouse such beliefs.

The main hindrance to religious people wholeheartedly embracing evidence as divine communication – divine guidance (i.e., how Reality reveals itself) – has been what I have long been characterizing as idolatry of the written word (also here). Idolatry of the written word occurred anywhere in the world where ancient oral stories (which surely evolved for millennia as conditions and needs changed) became frozen into unchanging scripture – scripture that was then deemed as the foundational (even the sole) locus for discerning priorities, values, right thinking, and right behavior.

This shift from oral storytelling to unchanging scripture as the way wisdom, morality, and a sense of the sacred (supreme value) is generationally passed forward set the stage (albeit centuries later) for a profound and now exponentially expanding mismatch. This mismatch is between globally shared and empirically tested updates of (once-again) evolving wisdom versus what religious people still preference as “God’s Word”.

Idolatry of the written word has thus led to what could be considered “demonic beliefs.” I do not hesitate to use such harsh language because any and all beliefs that cause good people to do bad things and to vote in evil ways (ways that are shortsighted, self-centered, and harmful to future generations) are demonic. And who among us does not see where such beliefs have led to a kind of collective insanity? The only cure, as far as I can tell, is for religious leaders to accept – indeed, to celebrate – that scientific, historic, and cross-cultural evidence are the actual venues through which Reality/God is speaking and guiding humanity today. Fortunately, this shift is happening rapidly…and seems likely to be fleshed out in just another generation or two.

I do not decry or disvalue this aspect of religious history. Indeed, I accept that idolatry of the written word could not have been avoided. Without the shift to literacy, humanity would never have been able to access the fruits of modernity: the rule of law, exponentially growing knowledge, cumulative technological and medical advances, and a widening sense of one’s “in-group” and compassionate treatment thereof.

Nonetheless, the negative social consequences of this form of idolatry have been quite severe – and threaten to become even more terrifying and destructive as deadly weapons come in ever smaller packages. It is thus time to prophetically speak out against continued favoring of ancient scriptural ‘authority’ over our best collective understandings of facts and values today. Said another way, the Church, currently shipwrecked (also here) on the immovable rock of “biblical authority”, can still be saved, but only by embracing “the authority of evidence”. Reality would have it no other way.

Our Way Forward: Aligning Self-Interest with Species-Wide & Global Interests

One of the most significant and hopeful insights to emerge from the early days of the Evidential Reformation is a re-envisioning of what “self-interest” really is. Self-interest actually exists at all biological and cultural levels – not just at the obvious, individual level. Indeed, the key to ever-increasing social complexity in the human realm over the past 10,000 years has been the aligning of self-interest at multiple levels. It could even be argued that nothing is more important for ensuring a just and thriving future than aligning the natural self-interest of individuals, corporations, and nation-states with the wellbeing of the body of life as a whole. The outcome of this shift would be to make competition co-operative, self-interest nontoxic, and society wise.

One could thus conclude that humanity’s “Great Work” in the 21^st century is to co-create global and bioregional governance such that individuals and groups that benefit the common good benefit themselves, while individuals and groups that disregard or harm the common good are taxed, penalized, or face moral strictures.

By organizing and managing ourselves so that the impact of parts on the whole, for good or ill, are reflected back to the parts, we shall create a system through which individuals, corporations, and nations are incentivized to do what is just and ecological – while simultaneously being incentivized to not do what is unjust or un-ecological. This aligning of self-interest at multiple scales would ensure that what is perceived as the cheaper, easier, more convenient thing to do is also the right thing to do, rather than the harmful thing, as it is now. This re-incentivizing of societal goods and services to comport with human nature (as it really is, not as we wish it would be) would also help all elements of society to access and make decisions based on humanity’s collective intelligence (also here and here).

The promise of the Evidential Reformation, as I see it, is this: As the world’s great religious traditions come to honor and celebrate evidence as divine guidance, and big history as our common creation story, they will begin to wield their moral authority in ways that assist, rather than resist, the passage of our species out of the desert of destructive and unsustainable adolescence and into the promised land of contributing and fulfilled maturity.

Larry the Lounge Lizard

by Shane Dowd

Isn't it neat to know that we all have lizards and furry li'l mammals living in our heads, running our lives?

Ok, maybe not exactly, but as we learn more and more about evolutionary brain science and evolutionary psychology, as well as gain more evidence about our amazing ability to rationalize and self-deceive, the analogy becomes less fantasy and more spot-on than we might imagine.

A person might be inclined to be a bit worried at the thought of scaly lizards and furry creatures running amuck, inside our brains. However, to me, this news is far from disconcerting. In fact, this knowledge gives me compassion to lighten up on myself and others when our "inner animal" or "shadow" nature, or "darkside" flares up, and wisdom about how to live my life in spite of being a human being with mismatched instincts in a world of supernormal stimuli.)

I invite you (yes YOU reading this post) to think about those times when you have felt deep shame and condemnation for certain aspects of yourself and others. You know the feeling, deep inside, that despises the part of you that you keep hidden from others? Those lustful feelings that you "shouldn't" be feeling, those food cravings that you just can't control? What if all those urges were actually perfect? Not as some "airy-fairy" new-age proclamation that "you're perfect just the way you are," but as an actual fact that modern science has uncovered?

What if this "dark" part of yourself that lusts and hungers out of control is actually perfectly adapted to serve an evolutionary role? What if that very instinct is the very reason you even exist? After all, if your ancient ancestors didn't have those very same instincts, they wouldn't have been motivated to seek as much food as they could in preparation for the famine, or go chase after the pretty cavewoman (well..."pretty" might be stretching it for a cavewoman :-). My friends, it's time to turn and give a big ol' hug to our "shadows!"

To me, that is what an evolutionary perspective provides: the ability to compassionately look at yourself and others, "flaws" and all, and KNOW that you are perfect...that is, perfectly adapted for the environment your brain evolved in, I should say.

To me, this knowledge has been personally and relationally transformative. I can now plainly see, often in the moment, the lizard, mammal, and monkey that are pulling on the levers and dials of my thoughts and actions, while my higher brain (neocortex) rationalizes every move and pretends IT is running the show!

Also, knowing that these instincts (for safety, sustenance, and sex) have refined and ingrained themselves for MILLIONS OF YEARS, I see what I am up against. The words "precautionary measures" start to seem like a really good idea...

After all, do I really think that if I try to fight against these urges, or condemn them, that they will be any less potent? Do I really think I don't have to put in place any structures to override these primitive urges (using accountability, social support, etc), that this lizard / monkey / animal won't get its way sometimes (or most of the time in all likelihood?)

Did I mention the CRAFTED OVER MILLIONS OF YEARS thing?

In terms of the oldest part of our brain (the reptilian brain)... When I think that, in effect, there is a little lizard (I call him Larry) inside the deepest part of my brain, who desires to eat sugary, fatty, salty food and wants to mate with every attractive female that he sees, it suddenly becomes dramatically easier to be one step ahead of him, while smiling at his wily ways.

When a beautiful babe walks by, Larry chimes in, "Hey, look at her! Maybe she'll look back at you, which could lead to some innocent flirting, which could lead to... (you know where Larry is going with this one. :-)

Equipped with this knowledge about "Larry" and what he wants, compared to what I am actually committed to, instead of indulging his every whim I can now chuckle, make a joke about Larry's primal urges (often with my girlfriend, which is SUCH a gift to both have this knowledge), and move on with my day.

Also, regarding Larry's penchant for sugary, salty, and fatty foods, this knowledge allows me to put in place the support that will have me making wise nutrition and exercise choices (accountability around sticking with an exercise program, stocking my house only with 90% healthy options, so that Larry isn't tempted, etc).

I know that millions of years of evolution backing these urges for sugar, salt, and fat is nothing to trifle with!

To me, this understanding is vital for having exactly the kind of life I want and relationships that truly work. I now see plainly what inner forces are in me, what they are likely to pull me towards, and what I need to do or put in place to make wise, healthy, integrous choices.

Kick-ass!

P.S. I want to give a shout-out to my homey, "Larry the Lounge Lizard." You got me a long way ol' boy! But you can relax for now. I promise there will be food and fornicating in your future!

P.P.S. For more information about Larry and the other animals inside your brain, check out all the amazing resources on this page!

The above was written by Shane Dowd. (It's his very first blog post.) Click on Shane's name on this page for more background on him (and to see his gorgeous girlfriend).

Death, Budgets, and Generational Justice

by Connie Barlow

"We think the budget mess is a squabble between partisans in Washington. But in large measure it's about our inability to face death and our willingness as a nation to spend whatever it takes to push it just slightly over the horizon."

That's how New York Times columnist David Brooks concluded his courageous July 2011 essay, "Death and Budgets."

A month earlier, Daniel Callahan and Sherwin B. Nuland co-authored a similar call to action published originally in The New Republic and also available online, "The Quagmire: How American Medicine Is Destroying Itself". These renowned experts on the medical and ethical issues of death and dying contend,

"In the war against disease, we have unwittingly created a kind of medicine that is barely affordable now and forbiddingly unaffordable in the long run. The Affordable Care Act might ease the burden, but it will not eliminate it. Ours is now a medicine that may doom most of us to an old age that will end badly: with our declining bodies falling apart as they always have but devilishly — and expensively—stretching out the suffering and decay. Can we conceptualize something better? . . . Can we imagine a system that is less ambitious but also more humane — that better handles the inevitable downward spiral of old age and helps us through a somewhat more limited life span as workers, citizens, and parents?"

Callahan and Nuland continue, "The answer to these questions is yes. But it will require — to use a religious term in a secular way — something like a conversion experience on the part of physicians, researchers, industry, and our nation as a whole."

Amen!

This is precisely why, when presenting an evolutionary picture of death to religious and secular audiences alike, I aim to parlay information and anecdote into a concoction that just might evoke a conversion experience. Here is one success story, drawn from an email I received in 2007 after delivering a sermon, "Death Through Deep-Time Eyes," at a Unitarian Universalist church in the Midwest:

"I am a funeral director intern and will be getting my license within the next couple of months. Every day I deal with death. Every day I hear sermons about Adam's sin and death's sting. I always feel strange, sitting at the back listening to whichever preacher happens to be the pick of the day. I always knew I didn't believe what they spoke.
I learned about evolution and the Big Bang from teachers who didn't believe in it, but who had to teach it. I watch programs on it on the Discovery Channel. I believe it. But I have never had it put into a story that could define me. It was always distant, something that happened in the past. You brought to me the first creation story that I could relate to. No talking snake in a tree tempting a nude woman. No. You gave me words to a story that is based in fact — something I can make my own, something that is my own. And for that, I thank you."

Death denial in our culture is not only entrenched; it is the default perspective because of our dominant religious heritage. A large segment of the American population still believes (or regularly listens to preachers who believe) in the Bible literally. For them, the explanation for why there is death is drawn from Romans 5:12 (attributed to the writings of the Apostle Paul): "Wherefore as by one man sin entered the world, and death by sin; and so death passed upon all men."

Death in our culture is seen as bad and wrong. Death simply shouldn't be. How do we know this? Because ancient oral stories unfairly frozen into unchanging scripture — what Michael Dowd calls, "idolatry of the written word" (also here) — claim that there was no death in the beginning — at least no death of animals. Not only did the lion lay down with the lamb, but even T. rex is said to have been a vegetarian in those halcyon days when our species numbered merely two. (Note: If you are unaware of this literalist explanation for how death came into the world, take a few moments to read online a creationist tract on this topic, in cartoon format — or visit the Creation Museum in northern Kentucky.)

Not only do teachers and preachers of fundamentalist leanings point to scriptural passages that portray death as "the enemy" (1 Corinthians 15:26), but the culture of our medical institutions reinforces it. Death-as-enemy, sadly, is reinforced, as well, by the economics of the ratings systems for doctors and hospitals.

And thus I regularly challenge my audiences by proposing that, "No generations before our own, anywhere on Earth, experienced more prolonged emotional anguish, family discord, and even physical suffering in relation to the passing of elders than do the generations of Americans alive today."

David Brooks, Daniel Callahan, and Sherwin Nuland have now given me the courage to add, "and none of the multitudes who came before us had an opportunity to die in ways that were as flagrantly heedless of the well-being of future generations as the end-of-life practices that prevail today."

Consider, for example, the illness of aging that is the most emotionally and financially devastating of all: dementia. Back on the farm, when grandpa entered the night-wandering phase of (what is now called) Alzheimer's disease, there would have been no locks on doors. Indeed, when little Johnny noticed grandpa on his way out one cold autumn evening, mama would likely have said, "Hush, child. It is Grandpa's time to go." Next morning, Grandpa would be found asleep in the barn or the hayfield — no, dead. Death by hypothermia is actually not a harsh way to go. It begins with sleep; the aftermath looks like sleep.

If Grandpa survived the wandering phase of Alzheimer's, however, then when he lost the ability to respond to hunger and to feed himself, no one would insist on doing it for him. Or if a stroke broke his capacity to speak and swallow, no one would rush to install a feeding tube. Rather, "Hush, child. In his own way, Grandpa knows his time is over."

And when an elder became bedridden for any reason — heart failure, broken hip, stroke — it would not be long (especially in the winter months) before sluggish lungs would welcome home "the old person's friend": pneumonia.

In contrast, several decades ago, my cousin received a call from the late-stage Alzheimer's facility where my aunt had been bedridden for several years. Long a victim of bedsores, she had finally contracted pneumonia. When my cousin suggested that no antibiotics be given, he was scolded, "You mean you want to kill your mother?!"

Many of us carry stories such as these. Indeed, by the time we reach middle age, almost all of us have at least second-hand awareness of the horrors that arise from the reckless availability of and passive submission to advanced medical interventions that do no more than buy a little time before the next medical intervention is advised. Those increments of weeks and months are purchased at enormous cost. For what? And, just as importantly, by whom?

Probably not by me: I am 59 and my nation is still piling on the debt and allocating ever more of its tax revenues to paying interest on and rolling over old Treasury bills.

No. Those who will ultimately pay for keeping grandma institutionalized, drugged, and strapped to her chair or for spending the equivalent of a half dozen college educations in the final six months of grandpa's dwindling life will probably be the age group whose life prospects are already shrunken and gray, owing to levels of college debt and underemployment that my generation would have considered immoral if not insane.

So, yes, I stand with David Brooks. I stand with Daniel Callahan and with Sherwin Nuland. I stand for generational justice and compassion and care for the dying — including those for whom death would be a blessing and would naturally come if we would but stand back and allow it to run its gentle course.

So let more of us dare to speak what we already know: heroic efforts for the disabled elderly are all too often demonic. Whatever communal good our elders contributed while still hale and hearty, however proud their legacy to offspring, community, and nation, the ways in which they (and more often "we") manage their end of life care and choices will determine not only how we remember them but what they effectively pass forward.

Will we allow them to pass forward a healthy and prosperous future to the generations in waiting? Or will our sick assumptions about death-as-enemy consign them passively to the negative side of the ledger? Will we who make the decisions in their stead fail them in our final acts of love?

"Hush, child. This is Opa's final gift to you and to your children to come. One day, many, many years from now, it will be your time to pass the gift forward. And you will be grateful for that opportunity, just like, in his heart, Opa surely now feels."

This is a vision that I find beautiful — as well as necessary. And I speak from experience, thanks to the simple generosity of an ordinary woman who allowed me to walk to the threshold with her, arm in arm.

As I've written about elsewhere, in 1998 my mother fought her way out of the hospital after yet another heart attack (she had received bypass surgery eight years earlier). She explained, "Con, I don't want my grandchildren paying for this anymore."

As a General Motors widow and Medicare beneficiary, Helen knew that "her" grandchildren paid not a dime. But my mother considered all the grandchildren in America as her responsibility. And so, yes, her grandchildren would indeed be paying for the next stent or pacemaker or whatever would be installed this time around.

She even refused diagnostics: "I don't need to know how much I damaged my heart this time, Con. I want to go with a good old-fashioned heart attack — just like my mother did." And so I was invited to return to live with my mother, to help her walk the final path toward her own notion of an honorable death. I felt privileged to comply.

As a freelance writer, with no children to care for, and whose worldview could be trusted to honor my mother's wishes, I would be the helpmeet for this final phase of her life. Five weeks after I moved in and helped her cross off item after item in her final to-do list, she and I together accomplished her three-fold wish: to die at home, with no pain (well, reduced pain, thanks to morphine), and with someone to hold her hand.

Simple. And it was. Yet how few of my peers have a parental end-of-life story as vibrant, even joyous, as mine?

This essay is thus a call for generational justice, for generational generosity. It is a call for a religious conversion of sorts. To begin, let us more widely share our stories of elegant and triumphant deaths. And let us share the stories, too, where it just seemed to all go wrong — and for far too long.

It is time, as well, to share the sad new stories accumulating of youthful dreams closing down — like the story of one young woman in Eugene, Oregon. With a master's degree in Communication and an abundance of student debt, she was grateful to have the same job she had held as an undergraduate: on a call line in a Verizon Center. "All the nonprofit job opportunities are taken," she told me. "So, none of my student loans will be forgiven. My biggest decision now is whether to try to pay them off in 12 years or 20."

What about your dreams? I asked.

She looked at me incredulously — as if I had spoken in a foreign tongue. Her boyfriend, sitting alongside, glared at me. In that moment, I was just one more over-indulged boomer whose generation was largely responsible for the mess those two had inherited.

Earlier in the conversation I had committed another faux pas. The young woman had told me the story of her beloved grandmother, who encouraged her so much as a child, but who now was saddled with dementia in a nursing home. "Do you realize," I said matter-of-factly, "that just six months of what it costs to take care of your grandmother would probably pay off your entire college debt?"

The point of this essay is not to restate "The Case for Killing Granny" (which was the cover story of a September 2009 issue of Newsweek). It is not advocacy for medical rationing or any other top-down directive. Rather, I wish to invite other boomers and what remains of the generation ahead of us to co-lead a bottom-up initiative to just say no to unrealistic, dishonorable, and supremely costly interventions that only prolong suffering — not life. If even a fraction of us do this, then rationing of health care will not be necessary.

Fortunately, we are already on the cusp of a revolution in medical practices that will boost our ability to say no to costly diagnostic testing. The impetus? Data now reveal that standard diagnostic tests (PSA tests, mammograms) for the asymptomatic middle-aged and elderly cause more harm than good. The cover story of an August 2011 Newsweek (titled, “One Word Can Save Your Life: No!”, by Sharon Begley) begins,

Dr. Stephen Smith, Professor emeritus of family medicine at Brown University School of Medicine, tells his physician not to order a PSA blood test for prostate cancer or an annual electrocardiogram to screen for heart irregularities, since neither test has been shown to save lives. Rather, both tests frequently find innocuous quirks that can lead to a dangerous odyssey of tests and procedures. Dr. Rita Redberg, professor of medicine at the University of California, San Francisco, and editor of the prestigious Archives of Internal Medicine, has no intention of having a screening mammogram even though her 50th birthday has come and gone. That’s the age at which women are advised to get one. But, says Redberg, they detect too many false positives (suspicious spots that turn out, upon biopsy, to be nothing) and tumors that might regress on their own, and there is little if any evidence that they save lives.

But overuse of advanced medical procedures goes beyond diagnostics. It includes costly interventions that have become standard procedures. Begley writes,

The dilemma, say a growing number of physicians and expert medical panels, is that some of this same health care that helps certain patients can, when offered to everyone else, be useless or even detrimental. Some of the most disturbing examples involve cardiology. At least five large, randomized controlled studies have analyzed treatments for stable heart patients who have nothing worse than mild chest pain. The studies compared invasive procedures including angioplasty, in which a surgeon mechanically widens a blocked blood vessel by crushing the fatty deposits called plaques; stenting, or propping open a vessel with wire mesh; and bypass surgery, grafting a new blood vessel onto a blocked one. Every study found that the surgical procedures didn’t improve survival rates or quality of life more than noninvasive treatments including drugs (beta blockers, cholesterol-lowering statins, and aspirin), exercise, and a healthy diet. They were, however, far more expensive: stenting costs Medicare more than $1.6 billion a year.

By the time the first boomer reaches three score and ten, I see us coming together as a generation, once again, and declaring something along these lines: that until every 20-something in America, and every 30- or 40-something with kids, has taxpayer-supported health insurance, and until there are community service options for working off college debt, we boomers will refuse to tap Medicare for any heroic medical interventions beyond our 70s. If we can find a way to ensure that all the youth have a chance to create a full and contributing life, and that they receive no less taxpayer support for their health care than we do, then maybe (or maybe not) we'll accept a Medicare-funded bypass or pacemaker or cancer surgery or hip replacement in our 80s.

But until the day that generational justice is assured, we'll foment a new revolution. Not just dignity, but death done with generosity, death done with celebration and joy and play. Death done in a way that leaves a legacy — not of insupportable debt but of wondrous stories of light-hearted farewells and crazy, cool send-offs. Perhaps like the one I heard about just last week.

My husband, Michael Dowd, and I were theme speakers for a week-long church summer camp in the San Bernardino Mountains of California. For nine years we have lived entirely on the road as "America's evolutionary evangelists," bringing the saving good news of a mainstream scientific naturalism to communities from coast to coast. For this particular summer camp we divided our twin talks into "Evolutionize Your Life" (Michael's topic) and "Evolutionize Your Death and Legacy" (my own).

After each talk outdoors under the pines, the group would re-assemble on the lodge porch for "Talk Back," for which I solicited stories rather than comments and questions. And the group happily obliged. There were stories of trauma, stories of prolonged drama, stories dire enough to ignite a revolution. And there were a few stories as glorious as mine with my mom.

One young woman told of how her grandfather, who was dying of cancer at home, called for a final party. Family and friends arrived and told stories and cried and laughed together. Her bedridden grandfather did too. Then the old man signaled for a pre-arranged final gift: an extra dose of morphine. He closed his eyes. He died not in secret, not with shame, but with celebration and love — and with this story as his final gift.

So let's proclaim a revolution that, clearly, has already begun. I suggest a six-fold path that each of us, as individuals and in small collectives, can walk. Consider my suggestions; then offer your own.

Step 1. Seek out a spiritually fulfilling way to embrace death, rather than fight or fear it.

In my own presentations, audios, and videos, I advocate the Epic of Evolution — Big History — as the science-based worldview that can allure us into befriending death. A variety of sciences have revealed that death not only plays a necessary role, but also a creative role in the emergence of complex atoms and then life and complex life and culture in this universe. I also recommend the award-winning documentary "Griefwalker," which movingly explores the death-and-dying work of Canadian Stephen Jenkinson. The "Griefwalker" worldview (born of ecological, place-based native wisdom) is compatible with my own — and with any other secular or religious perspective that does not make of death an enemy. (See my husband's poignant post: "Thank God for Death—Could Anything Be More Sacred, More Necessary, More Real?")

Step 2. Do not wait for middle or old age to begin your spiritual work of embracing your own inevitable death and the deaths of those you love.

There are two powerful reasons to befriend death sooner rather than later. The first reason is for your loved ones; until you can celebrate death as a natural, necessary, and sacred part of the circle of life, you will be like a bull in a china shop when in the presence of those who are consciously and gracefully dying. Worse, you may be the recalcitrant family member whose death denial makes medical staff wary of a lawsuit if they do anything less than everything for your loved one slipping away. The second reason to do the work now is best expressed by Stephen Jenkinson: "Not success, not growth, not happiness; the cradle of your love of life is death." If you want to live fully, then invite the specter of your own death to become your cheerleader for vibrant living.

Step 3. Extend your sense of self as you age — to your descendants, to the generations to come, and to the larger body of life.

Perhaps the easiest way to shed your own fear of death is to cultivate a sense of, what Thomas Berry called, your "Great Self." Perhaps begin with redefining yourself within the river of time. Your small self is the whirlpool or the standing wave; your Great Self is the river. As well, Joanna Macy, Arne Naess, John Seed, and other proponents of "deep ecology" offer profound writings and other resources for cultivating an "ecological self." For me, the extended-self image I lean toward is that I might feel no more loss at the moment of death than that of a tree losing but one of its leaves.

Step 4. Attend (with gusto) to your legacy throughout your middle and later years.

One's deathbed is not the time to regret how little of merit, of lasting value and consequence, you may be passing forward. Instead, discover the joys of giving, of volunteering, of mentoring, of contributing to the younger generations your natural gifts of heart or mind and your acquired skills and wisdom. If you raise children during your life, a perfect time to gently invite legacy-consciousness into your choices is when the last one finally leaves home.

Step 5. Seek out opportunities to share your death-friendly perspective and to evoke compassionate listening of the perspectives and stories of others.

Explore various ways within your family, church, and community to formally and informally share best practices for overcoming death anxiety and for encouraging an ethic of generational justice and generosity. "Best practices" include how to firmly, but lovingly, communicate our desires, our intents, and the moral drives that ground those commitments to family members who may have trouble hearing and graciously accepting the choices we intend to make. And there's nothing quite as life-giving as expressing heartfelt gratitude to those who have positively impacted you in some way, or sorrow/regret and a sincere apology to those you've consciously or unconsciously harmed.

Step 6. Take a deep dive into reconsidering the dance between individual rights and broader responsibilities in the death and dying process and in advanced care for the elderly.

"Right to die" ideally would be accompanied by an ethic of responsible communication — a commitment to lovingly (but firmly) communicate one's intent with all loved ones for whom withdrawal from medical intervention or active life termination may conflict with religious or other norms — or for whom death anxiety is so strong that conversation about death is difficult. As well, those who actively choose generational generosity rather than costly medical interventions have a unique and powerful opportunity to heal estranged familial relationships and tarnished friendships. Not only does impending death signal a "last chance" for reconciliation, but it is not unusual for those who calmly and clearly renounce medicalized dying to access remarkable psychological resources of patience, power, and empathy. It is then that miracles can occur: old relational wounds truly can be healed. Just as important, clearly communicated and legally enforceable intents and actions are essential for preventing new rifts among family members that may ensue if irresponsibility on the part of the dying pushes the decision-making downstream.

"Oh, Helen, you'll have to come again soon."

"Oh no, dear, this is the last time. It has been lovely."

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ADDENDUM: October 19, 2011. Another important article has come to my attention: “LETTING GO” by Atul Gawande, accessible online HERE.

The key fact it presents is this:

“In 2008, the national Coping with Cancer project published a study showing that terminally ill cancer patients who were put on a mechanical ventilator, given electrical defibrillation or chest compressions, or admitted, near death, to intensive care had a substantially worse quality of life in their last week than those who received no such interventions. And, six months after their death, their caregivers were three times as likely to suffer major depression.”

That led me to this insight:

Beyond cost and suffering, one of the saddest aspects of high-tech medicine in a death-denying culture is that it too often strips patients and family members of a basic human right: the right to end-of-life conversations. If a doctor is unwilling to acknowledge that an operation will only delay death, then too often the patient dies in surgery or falls out of cognitive capacities before final expressions of love, gratitude, and forgiveness take place. Or, because death is delayed, a family member flies in for a few days or a week or two, then has to return home to work and kids — but during that visit they cannot have a true final conversation because that would seem morbid or out of line if there is still ‘hope.’  So then they fly back again when death is finally acknowledged, but by then the patient is never really conscious, so the chance for a final conversation truly is lost. For most people it is not enough to be physically at the bedside as the loved one dies – if the time for final words has already passed.

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CONNIE BARLOW is the author of four books that celebrate meaningful understandings of mainstream evolutionary and ecological sciences. She and her husband, Rev. Michael Dowd, have spoken to more than 1,500 religious and secular groups since April 2002. Click HERE to see her writings, audios, and videos on death, which can also be accessed via her website, TheGreatStory.org