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Excerpt from “Ethical Concerns in Cancer Treatment”

“So just working with the effects of a cancer diagnosis as a disease vector on its own is very important. One of the most important things that tends to happen in our culture when a cancer diagnosis enters the picture is fear of death, usually ratcheted up pretty high. Terror might be a better word. Terror is morally crippling. People who are in the grip of fear of death—this is not conducive to the physiology of insight, even for the decision-making about their own lives. It’s a very primitive state. Looking at what’s happening just on a Western level in terms of brain, this is amygdala highjack. This is not a state in which higher cortical functions flourish. When somebody at first has received a cancer diagnosis, we have an ethical responsibility, I say, to help protect their freedom of choice, their free will, because no one has free will when they have lost heart and are awash in terror and are essentially an animal, ruled by fear.

So we know a lot about fear. We know a lot about reassurance, dropping, holding, helping the person come back to that state in which fear is present, no reason why not, but it’s in service of the heart, and from that place we go into the deep listening together.

What are the choices? What does free will—authentic will, not crazed animal, direct, in this moment, in this situation, for the client [look like]? Our psychologist yesterday, Marika, talked a lot about this, about the stress that comes from just the whole ambiance—needs to be recognized, needs to be brought in service of the heart. Okay. Chantal spoke so beautifully about what it is like when we are no longer living in mortal terror of death. We still have must what be called a certain caution. We still have a will to live. This is not passivity. This is not whatever. What’s the French equivalent of ‘whatever’? This is not whatever. This is a will to live in service of the heart. Okay.

How shall it go? I actually think it’s worth questioning where discussions of death and mortality enter into our relationship with clients early on. Bernard Shannon was saying that in his intake, he routinely asks, ‘So, are your affairs in order? If you were die on your way home from this appointment, are there any phone calls you wish you had made, any messages you would have wanted to give to anyone?’ I think this is a very good idea. Whatever we can do to help shift the conversation of death so that it is in service of the heart, and, when a client has an illness that may well be fatal, to feel what we feel about it, in service of the heart, in heart space, so that we are able to ask, ‘So, in light of this reminder of mortality—‘ We don’t have to say, ‘Given that you’re probably gonna die.’ But we can say, ‘In light of this reminder of mortality, what are you thinking, what are you feeling, what are you valuing? Is there anything more important to you than life?’

Because when we know that, we come into our alignment, and as we have heard many speakers pointing out, and studies from hospice actually show this—those who come into alignment with that which is more important than living or dying settle into a physiological state that is much more conducive to living, even though it’s no longer a battle. It’s not a fight, it’s not a striving, it is wu wei again.”