title: The "Endura" of The Cathars' Heresy: Medieval Concept of Ritual Euthanasia or Suicide?
abstract: The aim of the study is to explore the medieval concepts on the voluntary death of severely sick people, as they emerge through the endura (endurance) of the heresy of the Cathars in France (twelfth to fourteenth centuries). The endura was the prerequisite act of repentance that would allow the fallen soul to return to heaven. The endura was a necessary act of repentance, after the performance of a ceremonial purification of the soul (consolamentum), and consisted of the patients' voluntary abstention from vital food. The consolamentum and endura could be performed in the final stage of a disease with the consent of the patients or their relatives. The role of the Cathar physician was only to determine the severity of the disease and the forthcoming death of the patient. The physician was not allowed to take steps that would deprive the life of the patient, and the performance of the ritual endura was duty of the spiritual leaders of the community. The modern ethical approach to this subject is dictated by the medieval belief on the salvation of the soul and tries to answer the question of whether the endura could be seen as a medieval concept of a ritual euthanasia or fell within the theological sin of suicide.
authors.affiliation: Department of Microbiology, Athens Medical School, University of Athens, M. Asias 75, 115-27, Athens, Greece. ctsiamis@med.uoa.gr.
authors.forename: Costas
authors.initials: C
authors.lastname: Tsiamis
authors.affiliation: Department of Ancient Greek, Roman, Medieval and Byzantine History, Faculty of History and Archaeology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Tounta
authors.affiliation: Department of History of Medicine, Athens Medical School, University of Athens, Athens, Greece.
authors.forename: Effie
authors.initials: E
authors.lastname: Poulakou-Rebelakou
mesh_terms: D001293:Attitude to Death; D002562:Ceremonial Behavior; D028601:Euthanasia, Active / Q000266:history*; D005602:France; D049691:History, Medieval; D006801:Humans; D012068:Religion and Medicine; D013405:Suicide / Q000266:history*
keywords: Cathars; Endura; Euthanasia; Rituals; Suicide