Susan S. Phillips, PhD, is a sociologist, spiritual director, and writer whose work bridges Christian spirituality and the social sciences. For nearly three decades she served as Executive Director of New College Berkeley, where she also taught in partnership with the Graduate Theological Union. She has taught at Fuller Theological Seminary, Regent College, and San Francisco Theological Seminary. Susan delights in exploring how faith is lived out in daily life and how practices of care and spiritual attentiveness shape us as people. She is the author of several books, including The Crisis of Care, Candlelight: Illuminating the Art of Spiritual Direction, and The Cultivated Life: From Ceaseless Striving to Receiving Joy. Susan takes joy in accompanying people in prayer and discernment—whether in retreats, spiritual direction, or everyday conversation.
Death has a way of clarifying things. Accomplishments recede. Old regrets ask for attention. Relationships take on a different weight, and words left unspoken suddenly matter very much. As a spiritual director, Susan S. Phillips has had the privilege of accompanying people into precisely this territory—what she calls being invited “into the foxhole” with them. In this conversation, she reflects on what those encounters have taught her about dying, and therefore about living: the need to receive as well as give, to make room for both gratitude and grief, to reconcile where possible, and to say the loving thing while there is still time. MAiD forms part of the conversation, but a larger question runs beneath it: what might become possible when death is approached not simply as an ending, but as part of the spiritual work of being human?
Names mentioned:
Max Weber, David Maginley, Jesus, Lazarus, Mary, Martha.
Books mentioned:
Candlelight: Illuminating the Art of Spiritual Direction (by Susan S. Phillips)
Radix: You’ve worked as a spiritual director, sociologist, writer, professor, and lecturer. Each vocation offers its own perspective on what it means to live well—and to die well. How have those different roles shaped your understanding of death and the end of life?
Susan S. Phillips: As a spiritual director, you have the privilege of being invited into the foxhole with people. When people are suffering or approaching death, they often edit what they say to family and friends. They don’t want to burden others or invite advice or platitudes. Sometimes the magnitude of what they’re experiencing is simply too great for ordinary conversation. With a spiritual director, though, people often speak with remarkable honesty. Whatever they’re saying to God, the spiritual director gets to hear. Over time—and really this began when I was working as a counselor—I came to realize that many of the questions people bring aren’t questions that need answers. They’re prayers.
Someone will ask, “Why is this happening to me?” or “How can a loving God allow this?” When I was younger, I assumed I needed to provide an answer. Now I simply appreciate the honesty of those prayers and the trust they reveal. People are willing to bring those questions directly before God. So my understanding of how people approach the end of life has been shaped far more by accompanying people as a spiritual director—and simply as a friend—than by all the philosophical, sociological, and theological reading I’ve done. Those things become part of the background as I listen.
Radix: One thing I’ve always appreciated in our conversations is how you’ve described spiritual direction as helping people remember God’s activity in their lives. It’s easy to forget those moments. But hearing people express their deepest questions—and realizing those questions are themselves, as you said, prayers—puts you in a remarkably privileged position.
SP: Absolutely. It’s an enormous privilege. And, of course, accompanying other people also touches my own questions. Right now, for example, there are several people in my practice who are consciously preparing for what they believe is the nearness of death. One is an older woman with no particular illness who has simply spent the last year intentionally preparing herself for what she senses is coming. Two others have Alzheimer’s diagnoses, so they’re grieving not only the prospect of death, but also the gradual loss of the lives they’ve known. In some ways, that’s even more frightening.
Not long ago, one of my directees died. Looking back through things she had written me, I noticed how much gratitude had come to characterize her final years. She became deeply thankful, for the people she loved and for the life she had been given. For more than a year she experienced repeated hospitalizations where she came close to dying. At one point she wondered why God had preserved her life into her mid-seventies when so many others never lived that long. Eventually she realized she didn’t need an explanation. As she wrote to me:
“The invitation seems to be to surrender to whatever is my current reality. I don’t need to know why. I simply surrender to the reality that God has allowed me to remain alive, and I do not have to justify my existence.”
She admitted that her inner critic still visited from time to time, but she also recognized that she could still love others, even if she could no longer do many of the things she once enjoyed.
Reading through your questions, Matthew, I found myself thinking about what I’ve seen across many people I’ve accompanied through the end of life. One pattern stands out: people often need to attend to both the past and the future before they can fully inhabit the present. They address regrets. They make reparations where they can. Some intentionally contact everyone who has been important in their lives simply to say goodbye and express gratitude. Others surrender hopes they’ve carried for years but now know won’t be fulfilled. Then they begin preparing for those they’ll leave behind. They update wills, organize trusts, settle legal matters, and even declutter their homes so loved ones won’t have to carry that burden. The woman I mentioned had two dependent adult relatives for whom she handled all the legal and financial responsibilities. Before she died, she was able to transfer those responsibilities to other family members and even teach them how to manage them.
Once people have attended to both the past and the future, they often become much freer to live in the present. That present is filled with love and gratitude—but also with grief, because they recognize that a life they have loved is coming to an end. I wrote about one of these women in my book Candlelight. I call her “Ruth.” The evening before she died, she asked me to bring her Communion and anoint her with oil. I read the Twenty-third Psalm to her, and afterward she reflected on it.
She said:
“He does lead me in right paths. I’m past regretting all the dead ends I explored and the meandering and traipsing I did in getting here. It was all part of the path I was on, and now I know Christ was with me on it. He restores my soul. Part of that restoration is a shedding of regrets. I used to be riddled with regret and striving. I am forgiven. Now I feel at peace. I shall not want. I shall dwell with God.”
She had let go of both regret and striving. She was simply present with God. What made her story especially remarkable was that she had no spouse, no children, no living parents, and no siblings. Yet she was surrounded by a loving community of friends. She died in her fifties—far earlier than she had hoped—but she experienced what I would call a very good death.
Radix: You mentioned regret and striving. As a spiritual director, do you think those are struggles most people carry long before they’re facing death?
SP: I suspect you have as many thoughts about that as I do. Regret can be helpful if it serves as a prompt—a prompt toward repentance, reconciliation, or making reparations. But the Christian faith doesn’t invite us to remain in regret. We’re meant to confess, receive forgiveness, and move forward. In that sense, regret can begin a cleansing process. Striving is similar. Hope is good, and moving toward meaningful goals is good. But striving becomes unhealthy when our worth becomes tied to productivity—what Max Weber described as the “iron cage.” When our value depends upon what we accomplish, striving becomes its own prison.
Radix: There is a hospital chaplain I’ve interviewed, David Maginley, and one observation he made about the dying process has stayed with me. He suggested that the final stage of life often becomes a kind of purification. People reconcile with family, write letters, say the things they’ve always needed to say, and let go of ambitions that once seemed so important. Basically, the ego begins to fall away. It made me wonder whether we should actually welcome healthy regret earlier in life. Perhaps that, too, is part of preparing for death—and therefore preparing to live well.
SP: I think that’s right. Perhaps that’s one reason the Benedictine tradition encourages the practice of memento mori—remembering our death each day. It’s not meant to make us morbid. Rather, it reminds us to stay as clear with God as we can, to nurture healthy relationships, and to keep growing in love.
Radix: As Christians, we’re really meant to spend our whole lives preparing for death. Within spiritual direction, are there particular practices or questions you encourage people to consider as they approach that stage of life?
SP: For those who specifically ask me to accompany them in preparing for death, we begin by asking whether there’s anything that stands between them and God—anything keeping them from being fully open. We also look at their relationships. Is there anyone they need to forgive? Anyone they need to reconcile with? Sometimes those relationships involve people who have already died. Some directees imagine they may meet those people again in the life to come, so they spend time forgiving them, trying to see them as God sees them, and imagining who those people might be in God’s redemption.
Beyond that, I don’t come with a checklist. What I really do is listen for what’s most alive in the person’s heart and soul. For some, an old guilt keeps resurfacing, along with the fear that perhaps it will somehow keep them from heaven. When that happens, I usually say, “How would it be if we simply brought that question before God together?” So far, every person I’ve accompanied in that way has come out of prayer no longer carrying the same anxiety. I’m thinking of one person in particular who has brought the same guilt before God multiple times. Now, after praying, they’ll simply look at me and smile: “Oh yes—I forgot. God is love.”
Radix: [Laughter] It almost sounds as though grace becomes especially tangible in those moments.
SP: Yes. And sometimes it simply helps to have another person hold you in prayer.
Radix: Can you talk a bit more about what you mean by “holding” someone in prayer?
SP: I invite the person to bring whatever they’re carrying—perhaps that old guilt—directly before God, while I remain quietly present with them. It takes courage to place those deepest fears before God. Perhaps my presence, and even something as simple as a lighted candle, helps keep their attention on God rather than on the endless internal dialogue that so easily takes over. Many of my directees regularly use our time together for that kind of prayer. They tell me it’s difficult to enter into it alone.
Churches sometimes create space for this, but usually only briefly. In group spiritual direction, for example, one person shares uninterrupted for five or ten minutes about something of spiritual significance. Then the entire group sits in silence before God. When the silence ends, the first question I ask is always, “Did anything come to you in the silence that you’d like to share?” Those moments can be remarkably powerful. Quite often, something new emerges in the silence: sometimes a fresh awareness of what God may be saying. Only after that do the other members of the group begin offering their reflections. It’s another way a community can hold prayerful space for someone.
Radix: You’ve written and spoken for years about the importance of community. We hear words like “community,” “friendship,” and “grace” so often that they can become abstractions. This is unfortunate. Yet they’re enormously important. As people approach the end of life, what role does community play? Is it ever too late to cultivate it?
SP: One thing that has struck me is how many dying people become deeply attentive to their community—not simply in terms of what the community can do for them, but what they themselves can still give. I’ll return to Ruth because her story is published and I can speak freely about it. Remember, she had no spouse, children, parents, or siblings. I visited her in the hospital after a major surgery, when it had become clear that the cancer had spread to vital organs. She was holding her Bible and asked me about 2 Corinthians 4:7–12, especially the verse about “the life of Jesus… made visible in our mortal flesh.”
Ruth hadn’t been especially involved in church before her diagnosis. In many ways, it was her illness that drew her into a deep faith. I asked what drew her to that passage. She said, “That’s what I want. I want this suffering and dying of my body to bear witness to what faith allows.” That became her vocation. She even hosted an evening she called A wake for the Living—because she was still alive. She shared her faith with many people, including friends who were quite skeptical and even atheists. I suspect they were moved less by what she said about faith than by the way she embodied it.
I saw something similar with another woman who died recently. Her desire was simply to welcome whoever came. The truth is, when we’re dying, we don’t know who will show up. Sometimes those closest to us find it hardest to come, and that can be painful. Yet others, perhaps people who haven’t been especially close, suddenly draw near. In those moments, the person who is dying is still ministering to others, even while those others are caring for them.
Dying isn’t something separate from living. It is part of living. To bear witness to what faith allows—that’s a beautiful mission statement not only for dying, but for life itself. So yes, community is profoundly important. But it isn’t simply that the community supports the dying person. There is also a gift that the community receives. There is something deeply beautiful about sharing genuine intimacy with someone who is approaching death.
Radix: That’s something I’ve heard repeatedly while working on this Radix issue—whether from pastors, chaplains, or others involved in end-of-life care. Whatever one’s views on euthanasia or MAiD, many have spoken about the gift a dying person offers those around them. There are lessons that simply can’t be learned any other way.
Some have even suggested that’s one of the losses when life is intentionally shortened: because it isn’t only about what the dying person loses, but also what family and friends may never have the opportunity to receive. There can be something profoundly redemptive in accompanying someone through those final days.
SP: Yes, I can understand that. At the same time, I imagine many people choose MAiD because they don’t want to become a burden to those they love. That, too, often comes from compassion.
Before our conversation I did some reading about MAiD, and I noticed that “intolerable suffering” is one of the criteria for assisted dying. That’s a difficult phrase—intolerable suffering. The people I’ve been describing weren’t suffering intolerably. They experienced pain, certainly, and significant loss of capacity, but their pain could be managed. I can’t imagine wishing intolerable suffering on anyone. Nor is it easy to determine what is intolerable for another person. I imagine the ethicists and clinicians involved in these decisions carry an extraordinarily difficult responsibility.
Radix: It’s such a complicated issue. My grandfather was a physician, and he had no hesitation about ensuring people near the end of life received enough medication to relieve their pain—as much medication as they could possibly handle, and more—even knowing it might hasten death. That always struck me as the compassionate response.
At the same time, I struggle with both extremes of the debate. It’s difficult to tell someone in excruciating pain that relief must be withheld because of a particular principle or biblical interpretation. Yet it’s also difficult when much younger people, perhaps in their twenties or thirties—and this has already been happening – describe their suffering as intolerable and seek to end their lives. That I see as a problem. Anyway, the point is that these questions simply aren’t straightforward.
SP: No, they’re not. They’re extraordinarily difficult decisions, and I imagine even afterward people rarely feel complete certainty. What you describe about your grandfather was common before medically assisted dying became available. Physicians would sometimes increase morphine simply to relieve pain, even knowing it might shorten life. Those decisions were made compassionately.
Radix: A Canadian physician who has spent many years in palliative care shared something quite telling with me. She said that many people initially interested in MAiD tend to be relatively affluent and or quite independent. They’re accustomed to being in control of their lives. So while they don’t want to be a burden, neither do they want to lose control. She also said that this is reflected in the statistics. Yet she also told me that some of those same people change their minds about MAiD once they enter palliative care. They’re suddenly surrounded by people whose vocation is simply to care for them with kindness and compassion. Some have even said, “These are some of the best moments of my life. I finally feel alive.”
I find that heartbreaking. Imagine reaching the end of life only then discovering what mattered most all along. I mean, thank God they experience it at all—but it makes me think how important community is throughout life. Being in control isn’t the most important thing. It also makes me think pastors should be speaking much more about these things.
SP: Yes. There is so much loneliness. And many people find it difficult simply to receive. Receiving from other people—and even receiving from God—can be surprisingly hard. We’re so accustomed to thinking about what we can accomplish, contribute, and produce.
Radix: And Western culture surely reinforces that. It’s the water we swim in, so we hardly notice how deeply those assumptions shape us. But near the end of life, they suddenly become impossible to ignore.
SP: Exactly. We can easily begin to think of dying itself as a failure. We live in a culture where technology entrepreneurs invest enormous resources trying to extend life indefinitely through various means, like cryonics and other approaches. Against that backdrop, death can come to feel like something we’ve somehow failed to overcome. Though it’s not only a secular temptation. I’ve seen it within the church as well.
When I was in my thirties, a close friend was dying of cancer. Eventually she found it difficult to speak honestly in her prayer group. They were loving people who faithfully gathered around her, but they believed that if she simply had enough faith, she would be healed. That left her unable to speak openly about the reality she was facing. Even now I encounter people caught in that same bind. It places all the responsibility on the sick person, as though death itself is somehow abnormal—or evidence of failure. I think that’s a distinctly modern way of thinking, particularly in the Global North. In societies where there are fewer medical resources to postpone death, there’s often a greater acceptance that mortality is simply part of the human condition.
Radix: Speaking of the human condition, my father has spent a good amount of time in several African countries—he just loves their culture—and he often talks about attending funerals there. He was struck by the openness of the grief. Grown men would weep openly for days. At first he didn’t know what to make of it. Then he began to wonder whether there was something profoundly healthy about allowing grief to be fully expressed.
I’ve experienced something interesting myself after losing someone close. I don’t usually struggle to express emotion, but somehow I put my grief on hold. But then it remained on hold without my intention. It remained buried for nearly a year before finally emerging, after I finally made room for it. That made me realize how maybe our Western culture doesn’t really teach us to mourn well. We’re often afraid of vulnerability—afraid of what might happen if we truly let ourselves grieve.
SP: I think entering fully into mourning and lament is itself a kind of cleansing. I’ve lost several dear friends over the past few years, and I’ve found that mourning and love belong together. Over time the grief becomes less acute, but it never disappears. We continue to miss those we have loved.
One of the last things Ruth said to me before she slipped into unconsciousness was, “I trust. I trust Christ. I’m grateful… and I grieve.”
That’s the whole truth.
She wasn’t eager to leave the party early. What we need are spaces where the whole truth can be held together—where we celebrate a life while also acknowledging the profound loss of that person’s presence among us. Those spaces should make room for emotion. Sometimes our Christian services become a little too triumphalistic. People who need to weep don’t always feel there’s room for tears, or they worry others will think something is wrong with their faith.
Radix: That’s one reason I find Jesus weeping at Lazarus’s tomb so moving. If anyone knew that everything would ultimately be all right, it was Jesus. Yet in that moment he entered fully into the grief of those around him. He didn’t dismiss it because resurrection was coming. He grieved.
SP: I agree. I remember discussing that passage with a small group of monks once. A couple of them suggested that Jesus was weeping because Mary and Martha didn’t yet realize he could raise Lazarus from the dead. I don’t think that’s right. I think Jesus was grieving Lazarus’s death and entering fully into the sorrow of those who loved him. Even though he would soon raise Lazarus, the grief was still real.
Radix: If you were speaking to an ordinary person—someone preparing to visit a friend or loved one who is nearing death—what wisdom would you offer? How should we prepare ourselves before entering that room?
SP: First, remember that God is already with you. You never enter that room alone.
Then listen.
Pay close attention to where the other person actually is, rather than assuming you already know. I remember visiting Ruth near the end. At one point she was laughing while I was the one in tears. She simply reached over, patted my hand, and said, “It’s all right, sweetie.” People who are dying aren’t always in the emotional place we expect. They may be filled with remarkable peace and even joy.
When I teach spiritual directors, I often use the image of an emotional teeter-totter. Someone may be experiencing both joy and grief at the same time. If we respond only to one side of that experience, we throw the balance off.
Suppose someone says, “I feel peaceful, and I grieve.” If I respond only by saying, “How wonderful that you feel peaceful,” they’ll have to say, “Yes—but I also grieve.” If I respond only to the grief, they’ll have to remind me that they also feel peace. Our task is to hold the whole experience together. That’s one of the greatest gifts we can offer another person.
Radix: If you were speaking to someone who knows they are nearing death, what would you encourage them to keep in mind as they spend time with the people they love?
SP: Above all, express love. The night before my mother died, someone was coming to visit whom she had often been quite critical of over the years. I remember saying to her, “You need to be nice. Whatever you say tonight will be remembered forever.” Bless her heart—she was wonderfully gracious. She showed genuine interest in the person, thanked them, and expressed how much she appreciated them.
After the visit was over, she looked at me and asked, “How did I do?” That was about twelve hours before she died. It reminded me that our final conversations matter. Of course, as you’re dying you need to care for yourself. You need to rest in God and not carry everyone else’s burdens. But people remember what you say to them during those final days. Those words often stay with them for the rest of their lives.
Radix: Right! Those times have an incredible amount of leverage, as it were.
SP: They do.
Radix: Is there anything we haven’t touched on that you feel is important?
SP: Only that it has been an extraordinary privilege to accompany people to the ends of their lives. I miss every one of them terribly, and I’m deeply grateful to have known them.
As for my own death, I don’t really know how I’ll approach it beyond the way I’m gradually approaching it now. None of us can predict that. So much depends on circumstances—including pain. But I do think conversations like this are valuable. They’ve certainly been helpful for me. Since you first asked for this interview, several friends have received terminal diagnoses, and I’ve attended a couple of memorial services. Preparing for this conversation has reminded me of what those people taught me as they approached death, and I’m grateful for that.
Radix: One related question that doesn’t always get discussed: what role do rituals play?
SP: I think rituals can be profoundly important. They can become ways of surrendering different parts of our lives. Ruth’s A wake for the Living gathering was really a ritual of gratitude. She thanked each person individually and told them what they had meant to her. I’ve seen similar gatherings with other people who were dying, where everyone had the opportunity to speak words of blessing, appreciation, and love, and the dying person could respond in return.
Those kinds of gatherings can also be especially meaningful for someone on the journey through Alzheimer’s before communication becomes too difficult. Family and friends can gather to share favorite memories, tell stories, laugh together, and simply remind that person how deeply they are loved. That, too, is a beautiful blessing.
Radix: I had a great-uncle who died very suddenly during COVID. Afterward I realized there were so many things I had wanted to say to him but never had. Typical, right? I had planned to visit him while I was in my home province, but life became busy—such a dumb excuse in retrospect – and then the opportunity was suddenly gone.
After he died, I began writing what were essentially living obituaries for a few friends who were still alive. I’d sit down, think and feel really carefully about the person, remember our shared experiences, laugh a little, cry a little, and then send them a letter describing what they had meant to my life. Especially while they’re still able to receive it, what a gift it is to tell them: “This is what you’ve meant to me; these are the ways you’ve shaped my life.” If my life is a garden, then you’ve planted some of the flowers that have made it beautiful.
SP: What a wonderful practice. And knowing you a little, Matthew, I know you already do that—even in your emails. You’re quick to tell people what you appreciate about them. We shouldn’t reach the end of life with kind words still stored away inside us. We should keep sharing them while we have the opportunity.
Radix: Pastors still have tremendous influence in people’s lives. If you could speak to pastors everywhere about accompanying people through the end of life, what would you want to say?
SP: First, I would encourage them to care for themselves. Churches are aging, and even relatively young pastors often find themselves walking with one parishioner after another through terminal illness and death. It can become emotionally overwhelming. I’d encourage every pastor to have someone with whom they can speak honestly and confidentially—a therapist, spiritual director, pastoral counselor, personal chaplain, or perhaps a small group of trusted clergy colleagues. They need somewhere to carry their own grief.
I would also encourage pastors to see themselves as part of the wider community surrounding the dying person. Rather than carrying the entire burden themselves, they can help equip others to be present. Many people simply don’t know how to accompany someone who is dying. Pastors are uniquely positioned to help families and friends learn how to do that well. I’ve seen pastors do this beautifully, and it makes an enormous difference.
Radix: As always, thank you so much. I appreciate not only what you write and teach, but also the wisdom you’ve gained through accompanying people so faithfully. One of the things that has frustrated me as I’ve listened to conversations around MAiD is how often we focus only on the ethical question itself. Those questions matter enormously, of course, but it’s easy to lose sight of the larger question: What does it mean to live well—and therefore to die well?
You’ve helped me think more deeply about that. I hope our readers will do the same. It’s such a large subject, and I’m grateful you’ve helped us see beyond the immediate debate to the broader reality of what it means to be fully human.
SP: I’m so glad you—and Radix—are willing to engage such important conversations.