Law As A Healing Profession

For you detractors who scoff at the idea of law as a healing profession …

I was inspired to write this post after reading a recent article by Mark Glover, “A Therapeutic Jursiprudential Framework of Estate Planning,” in 35 Seattle Univ. L. Rev. 427 (2012).

The author is an assistant professor at Louisiana State University.  The article begins with a reference to Moby Dick – specifically when Ishmael’s brush with mortality in the attack on the longboat in which he was riding was attacked.  Having survived the “jaws of death,” Ishmael subsequently puts his affairs in order and makes a will, and feels as if a stone was rolled away from his heart.  Glover’s article looks at therapeutic jurisprudence, the aim of which he describes as “to shape the law in a way that maximizes its therapeutic potential without undermining the law’s fundamental purposes.” at 429 (citation omitted).  Why did I read this article and describe it here?  Glover’s stated aim is to spread the word about therapeutic jurisprudence in the estate planning and administration context.  I was interested!

I liked his point about one of the “antitherapeutic”  aspects of making and finalizing a will – that the experience is essentially “taboo-defying,” and as such, tends to be upsetting to many people.  In my experience I think this is a stretch.  I work with many people who have been thinking about estate planning for a long time, and it takes them a while to come in and get started or to complete the process.  I can also say from my own experience of updating my will and POA just several weeks back, that a couple folks in my office looked at me as if I was not telling them something important about my life (or death).  Therein lies the taboo.  It is insidious!  Next he identifies seven concerns that psychologists have identified that lead to a fear of death:

  1. They can no longer have any life experiences;
  2. They may be uncertain as to what will happen to them if there is a life after death;
  3. They may be afraid of what will happen to their bodies after death;
  4. They realize they will no longer be able to care for their dependents;
  5. They realize that their death will cause grief to their relatives and friends;
  6. They realize that all their plans and projects will come to an end; and
  7. They may be afraid that the process of dying will be painful. (citation omitted)

Avoiding estate planning helps some people avoid thoughts of their own mortality. I must ask the practical question – and how is this a good thing? It is about perpetuating death-denial that pervades our culture.  The crazy thing is that busting the “taboo” of thinking about death by making an estate plan is – I believe – an invaluable way to think about what is important to us in our lives right now, and are we living the kind of life for which we want to be remembered?  I already broached this topic in an earlier post, about writing your obituary now. [link to post]  From this article I learned of a study that (more than thirty years ago) that referred to the professional estate planner’s anxiety about raising the issue of mortality with clients?!  I don’t think I know of colleagues with that type of skin.

Glover also looks at estate disputes and familial conflict and the tangled web of concern over who gets what when there are children and assets involved and everyone may not get along.  I liked his footnote citing an article by M. Begleiter entitled “Anti-Contest Clauses: When You Care Enough to Send the Final Threat.”  This is a primary reason that I advocate mediation clauses in wills. The mediation clause cannot, under present law, force disputing parties to go first to mediation prior to a challenge in court, but a testator can certainly express herself about how she intends her children to get along and resolve any disputes they may have. A good article by Lela Porter Love about mediating probate matters to preserve and promote family harmony can be found here.

In the second half of the article, Glover finally gets to looking at the “therapeutic consequences” of estate planning.  He seems to start with the premise that only sailors on whaling ships (like Ishmael) should be entitled to feel good about getting their affairs in order.  I would tend to disagree!  One of the first benefits he discusses is that of self-determination, namely that deciding in advance who will be your beneficiaries knocks out the possibility of others determining the distribution (even “the government” meaning state laws of intestacy).  He also cites a helpful article about the “Power Tools” of estate conflict management by Paul Fisher, available here.

Finally, I liked what Glover had to say about the will execution ceremony.  It is and ought to be recognized as an important achievement, one which should provide the testator an amount of satisfaction.  The typical will ceremony in Colorado involves two witnesses, and can provide a certain amount of relief in that the anxiety remaining about mortality will often be replaced by a feeling that a person has put his or her affairs in order.  The last bit of fascinating information in this article concerns the origins of the Nobel prizes.  Grover points out that Alfred Nobel was the reader of a premature and highly critical obituary, as it was erroneously originally reported that Alfred, not his brother Ludvig, had died of a heart attack.  As a result of the “merchant of death” description in the obituary, Alfred Nobel bequeathed the bulk of his family fortune and his family name to the prizes that rewards persons making contributions for the benefit of humanity.  I recommend this article for reading by anyone who questions the therapeutic benefits of making a will, writing a testament, or executing durable powers of attorney.

 

Write Your Own Obituary

Many of us who focus our practice on estate planning encourage our clients to write an ethical will or include a testament in their will. Is it “over the top” to write you own obituary while you are taking stock of what is important to you in terms of your property, end of life decisions and choosing trustworthy agents for your durable powers of attorney?  I would say no, not at all, and many people would agree.  What do YOU want to be remembered for?

You may have had the opportunity to write a funeral notice or obituary for a deceased parent or other relative.  For many of us this was quite difficult, so if we’re already doing the “heavy lifting” of making a comprehensive estate plan – why not include the obituary as well?  A helpful tip about writing your own obituary might include “remember, it’s not a job application,” so your résumé may not be appropriate; and you may want to think deeply about what you want to be remembered for – considering all the different people and facets of your life.  Click here for some helpful tips. If this still sounds like too much for you, you might consider taking stock of your life right now (after all, dying is part of life) or giving yourself another 20-50 years and coming up with an unconventional demise – as in another helpful article.  The writer Brad Meltzer’s Ted video is very thought-provoking, you can view it here and go through his exercise.  I like his legacy-based approach, which focuses not on what you did for yourself (your education, etc.) but what you did for others.

How to get started? You can stick with the more traditional template for the obituaries and funeral notices that you typically find in the newspaper, or you can go beyond that into what Meltzer suggests – look at your personal, family and community legacies (the “who” of remembrance), and beyond that into the “what” – the actions for which you want to be remembered.  Things like what you do for perfect strangers, for other people. Are you living what you want to be remembered for right now?  This is where the transformation can take place, because each of us has the choice about how we live right now, to be remembered for your kindness, acts or charity and the like – that is true immortality.  I think of G.K. Chesterton’s quote here: “There is a road from the eye to the heart that does not go through the intellect.”  I must thank Sue for giving me this idea for the post, in an  indirect sort of way.

 

 

New Insight Into Causes of Alzheimer’s: It’s Still A Mixed Bag

A recent Mayo Clinic study asked “Does Overeating Cause Memory Loss in Older People?”  This is just too simple – isn’t it?!

This study looks to be like many of the studies ongoing with new technology enabling brain scans and better targeted cognitive tests – preliminary and giving only “suggestions” about causal relationships.  It is indeed a slippery slope to identify the boundary between age related “mild cognitive impairment” and Alzheimer’s disease.  A bigger question of course is what does “healthy aging” look like for the unprecedented numbers of people over age 80 that presently reside on the planet?  There are also people (medical doctors) who question the whole categorization of Alzheimer’s and other forms of dementia.  The National Institutes of Health fact sheet on Alzheimer’s disease offers the following:

“Scientists don’t yet fully understand what causes Alzheimer’s disease, but it has become increasingly clear that it develops because of a complex series of events that take place in the brain over a long period of time. It is likely that the causes include some mix of genetic, environmental, and lifestyle factors. Because people differ in their genetic make-up and lifestyle, the importance of any one of these factors in increasing or decreasing the risk of developing Alzheimer’s may differ from person to person.”

A recent study in the United Kingdom led to a discovery that in mice, certain proteins may block the progression of Alzheimer’s, particularly the toxic effect of the amyloid-beta protein. Read it here.

One of the tricky things about Alzheimer’s is that its progression is far from uniform (except in the case of younger onset, familial Alzheimer’s, which is most likely what the patient of Dr. Alzheimer suffered from) and people suffering from dementia often die from other causes.  So don’t think that you can usually go into a neurologist’s or geriatrician’s office and get a conclusive diagnosis of Alzheimer’s or staging of Alzheimer’s, an effective treatment or a cure for Alzheimer’s or many other types of dementia anytime soon.

Here’s a rather odd twist in the field of dementia and spirituality – which hasn’t been studied much.  The original research article published by Amy Owen and colleagues at Duke University is entitled “Religious Factors and Hippocampal Atrophy in Later Life,” which is available here.  It is one of just a handful of studies about spirituality in later life.  Several previous studies had indicated positive effects for elders, especially those suffering from dementia, who were part of a religious congregation or community.  A Scientific American article by Andrew Newberg discusses the study in his article “Religious Experiences Shrink Part of the Brain,” and you can read the article posted May 31, 2011, here. It contains plenty of very interesting comments about the methodology, causality and other factors in the study and the conclusions that may be drawn from it.

Dementia and Baby Boomers – you don’t have to be old to suffer the ravages:  “Dementia’s Youngest Victims Often Defy Stereotypes,” in  USA Today online from March 23, 2012. Read it here.

Dying is Part of Life

Dying is part of life – so why is talking about it so difficult?  Many reasons for that unanswerable question, but now – more than ever is the time we can start reflecting.  Never have we had so many octogenarians and nonagenarians on the fact of the planet.  Many are living longer more productive lives than they ever dreamed possible.  Some, many of them women, are running out of money.  As the life-extending reach of medical technology continues, it forces many questions, some of which are very uncomfortable.  I just read Judith Johnson’s fourth installment in the series of posts about making peace with death.  You can read it here.

Not all of us are afraid of death (which is one thing) or afraid of the process (quite another for many of us).  The Woody Allen quip comes to mind: “I’m not afraid of dying, I just don’t want to be there when it happens.”  Why does the dying process have such a bad rap?  Is it the uncertainty of what is happening, where someone is going (or not) that makes so many of us turn away?  It is a taboo based on fear and avoidance, how odd that it is avoidance of the inevitable.  How does that turning away from dying get unpacked into steps you can try if you want to be “present” and make peace with death?  Johnson offers five practical steps:  (1) see death as normal (part of life); (2) don’t try to run away or avoid it – this is the biggest tip in my opinion because she touches on the recognition that “death is a great teacher of how to embrace and honor life more deeply;” (3) focus on being of service to those involved in the process; (4) be authentic and express yourself in loving ways; and (5) allow yourself to experience the full range of grief and sorrow that are all parts of dying, death and grief.

I ran across another article about a new course being offered on Gabriola Island in Canada called “Nothing Left Unsaid.”  It looks to be an extension of the hospice conversation and all the services it offers for those not necessarily in the end stages of an illness.  I found the article’s reference to grief perhaps being classified as a mental illness in the next DSM (Diagnostic and Statistical Manual), and that reminded me of another article about that very topic – “Should Grief Be a Mental Illness?” by Joseph Nowinski, Ph.D.  It seems this fear that grief will be classified as a mental illness originated in a January 25, 2012 article entitled “Grief Could Join List of Disorders” and announces that, based on a new report, the criteria for depression are being reviewed by the American Psychiatric Association and could be expanded to include grief in the DSM-V.  Where does this leave those of us who are challenging the death-denying traditions and practices in our own ways? I think it is life-denying, because death is part of life.

The mental health implications of removing the grief exclusion from the definition of depression in the DSM-V are controversial, to say the least. Most of old age, along with many aspects (behaviors) of childhood are now “disorders” or fall within some arguable definition of a mental illness.  What does this say about our culture and its views towards aging, the dying process and death?  It is more of the death denial in our culture.  According to many longevity seekers, death is not necessarily inevitable or the result of natural consequences, rather it is more like a disease to be overcome, a challenge to be bested.  This reminds me of Dr. Sherwin Nuland, author of “How We Die,” and several other insightful books  A recurrent theme in his books is forthright talk about aging, dying and many other life topics that tend to make us uncomfortable.  Next time I’ll write about another favorite doctor/author of mine.

Welcome to My Blog

I have a new logo, and I’m pleased to say that the day I purchased it and printed it out, I was able to ask a client what he thought about it, and he immediately recognized it as a tree and made the “tree of life” connection. Yes, that’s the tree I’m talking about! My logo is a tree that also looks like a person who is embracing a community. I think this is particularly relevant to what I do because I work to help my clients put together a holistic plan for their future – one that is consistent with the values a person has lived by and which honors the relationships with family and community members. Holistic planning can also involve peacemaking. The tree of life connection is especially meaningful to me because it symbolizes the transitory nature of our lives and the relationships, in the context of certain unchanging constants. The tree of life symbolizes a simple message of unity, that we are all part of a community and it is represented in a number of different cultures, myths, faiths and traditions across time and geography. It is an important symbol for my practice philosophy because I seek to assist my clients in identifying ways they can maximize the support and connections they need from others during their lives and so they can transmit their legacy after they are gone.

I mention the Tree of Life specifically on my blog page because my blog is the place where the diverse but related interests will converge. We have never before had so many 80 and 90 year-olds on the face of the earth. What are the implications for law, ethics, medicine, philosophy? These are all appropriate aspects of identifying a strategy for clients because a sound plan must take into account the “ripple effect” of individual actions that relate to financial, emotional, medical and physical considerations that are often relevant in the legal context.