What is an AMICUS?

The first recorded scholarly use of the word amicus dates back to the 9th century when the Latin term amicus curiae appeared in Roman law to describe a “friend of the court”. Although the function of an amicus curiae was to inform or guide proceedings, their services were rarely called upon during these medieval times. It was not until 1951 when the amicus curiae concept was adopted by English law and later by International law (particularly in relation to Human Rights) did this service find a home. Within these more contemporary legal settings, an amicus curiae is regarded as one (either an individual or an agency) who assists the court by furnishing information or advice regarding questions of law or fact. (1)  

The roots of the term amicus mortis is less well understood, but probably dates back to the 15th century and the time of the Black Death. The few clergy who survived the plague were unable or unwilling to attend to the vast numbers that were dying, and the task often fell to family or members of the community. These folk were referred to as amici mortis – friends of the dying – and the ars moriendi, a ten-page Christian handbook on the art of dying gave them information on how to guide the dying process and ensure that person’s salvation.

As overall health and survival rates improved, the ars moriendi tradition “faded back into the matrix of Christian prayer and practice” (2) and the responsibility of caring for the dying was once again in the hands of the Church rather than the community. It remained this way until the 20th century when the advent of hospitals saw ‘priests’ in white coats replaced those in cassocks.

The almost defunct role of an amicus mortis was revived in 1995 when Ivan Illich, writing in the British Medical Journal (BMJ), implored those who practice medicine to be a friend or amicus to the dying. He defined amicus mortis as “One who tells the bitter truth and stays with you [the dying person] to the inexorable end”.(3) Sadly his appeal was not heard, and over the ensuing 20 years the term amicus mortis appeared only once in the medical literature – a letter written by Doctor James Grogono and published in the BMJ Journal in 2000. (4) Dr Grogono cared for his dying wife at home, and like Ivan Illich, he advocated strongly for the amicus role saying, an amicus mortis is an important ingredient to ensuring a good death.

I would like to think the tide is changing and that there is now an increasing call to demedicalise death so that a person can be lovingly midwifed into death just as a newborn is midwifed into life. The art of midwifing death combines the best of the old (amicus mortis) with the best of the new (comfort measures). The amicus liaises with the healthcare team, supports, informs, empowers and advocates for the person who is dying (and their family) and is present to their psychosocial and spiritual needs. They create the environment where death is accepted as the natural end to life, and receives the respect and reverence it deserves. The task of an amicus is onerous and rewarding, and is only possible if the person seeking to fulfill this role embarks on their own journey of inquiry – they need to become an amicus to themselves.

(1)       Merriam-Webster dictionary. M-W.com

(2)       http://www.deathreference.com/A-Bi/Ars-Moriendi.h...

(3)       Illich, I. Death undefeated. BMJ 1995;311:1652-1653

(4)       Grogono, J. Sharing control in death: the role of an amicus mortis. BMJ 2000;320:1205

Written by Dr Michael Babarto

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