Nelson Mandela is Dying: Three Lessons for You and Your Family

Reprinted courtesy of Dr. Monica Williams-Murphy

By typical end-of-life definitions, Nelson Mandela is dying.  As this newsletter goes to print, he is in critical condition after a lengthy hospital stay, and has had multiple recent admissions. Those of us in the healthcare professions see this end-of-life equation all of the time: increasing severity of illness and frequency of hospitalizations plus advanced age almost always equals dying.

President Mandela is a case in point. A case followed closely by the world, but also foreshadowing what may happen with each of us at the end of our own lives. We can all learn the following three lessons from his end-of-life experience.

Lesson One: Recognize the End-of-Life Equation
On June 9, 2013, South Africa’s best-selling weekly newspaper, The Sunday Times, reported that Mandela’s long-time friend Andrew Mlangeni publicly stated: “You (Mandela) have been coming to the hospital too many times. You are not well and there is a possibility you might not be well again. He was being a good friend. Often, the only one willing to acknowledge what is really happening is the one who is approaching death himself. The rest of us: friends, family and even doctors, often choose to remain in a state of denial believing that more can be done to change the equation.

Lesson Two: Understand Decision Motivations
Many people want to keep Nelson Mandela alive at all costs, even if it inadvertently causes unnecessary suffering for him. Many people around the word love him and recognize his iconic peace promoting power in South Africa and abroad. However, our perspectives are underpinned by “our” desires for him rather than asking what he would desire for himself. Mr. Mlangeni, was also quoted in The Sunday Times article urging Mandela’s family to “release him” and “let him go.” This position is the most selfless and loving, but can also be the most difficult. Again, should we become involved in making end-of-life decisions for another, we must ask ourselves about the motivations for our choices. We should select care not based on what we desire or fear about our loved one, but should select treatments, which the dying would choose for themselves.

Lesson Three: Give Permission to Die
In South African culture, it is customary for the family to give final permission to die, to emotionally and spiritually release the one who is approaching death. At some point Nelson Mandela will receive the words, “We release you, Father.”  Rarely, in living, do we create occasions to bid such sweet offerings to those we love, but surely in the face of dying, we should utter the words, “Thank You,” “I Love You,” and “Good-bye…I release you.”

So, Nelson Mandela is dying (either shortly or in the not so distant future), yet he remains iconic, not only for South Africans, but for the rest of us as well. Take these three lessons from the end of his life and apply them to yourself and your own family. Then take his words and apply them to your life: “What counts in life is not the mere fact that we have lived. It is what difference we have made in the lives of others that will determine the significance of the life we lead.” ■

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