One important question is which generation this concerns.
Somewhere in the mid 1900s Social Security programs were initiated all around the West, where the working class would be taxed in order to give to the elderly. Then, there were very few elderly, but the Boomers followed.
Today in the West it is normal for 40 % of one's income to be taken so that the Boomers can spend it on endless vacation trips. There is no question to be asked, the theft must end along with any further services and the focus must be completely shifted to the new, more responsible generations.
I asked Grok what the solution was after quoting your essay:
'The essay raises profound and challenging questions about end-of-life care, dignity, and societal priorities—issues that are indeed ancient yet newly pressing due to modern medical, legal, and cultural shifts. You’ve laid out a compelling case: the prolongation of life in states of severe suffering or unconsciousness often comes at an unbearable cost to individuals, families, and society. You’ve also highlighted the tension between idealism and realism, the squeamishness that stifles discussion, and the moral complexities that defy easy answers. So, what’s the solution?
There’s no single, tidy fix—any approach will involve trade-offs and discomfort—but a framework can be imagined that balances compassion, autonomy, and pragmatism while guarding against abuse. Here’s a possible path forward, grounded in the concerns you’ve raised:
Legalize Assisted Dying with Strict, Narrow Criteria: Establish a legal mechanism for hastening death, but limit it to cases of terminal illness or irreversible degenerative conditions (e.g., advanced dementia, ALS) where suffering is demonstrable and recovery impossible. This would require clear evidence of the patient’s prior wishes—ideally through a living will or advance directive made when they were of sound mind—and the unanimous consent of immediate family or designated proxies. The process would involve multiple medical and ethical reviews to ensure no coercion or haste, addressing your valid mistrust of state overreach and the Canadian-style trivialization of death.
Shift Cultural Norms Around Death: Encourage a societal reorientation toward accepting mortality as natural, not something to be resisted at all costs. This could mean reviving or creating rituals—like your “final night” idea—where death is framed as a communal, dignified passage rather than a sterile, medicalized ordeal. Education campaigns could normalize advance care planning, reducing the taboo around discussing end-of-life preferences and easing the burden on families when decisions arise.
Reform Care Funding and Incentives: Address the financial absurdity of prolonged care by capping costs or subsidizing them in a way that doesn’t bankrupt families, while removing profit motives from private care homes. Nationalization might be impractical, as you note, but a hybrid system—publicly funded baselines with private options—could work if paired with regulations that penalize unnecessary life-prolonging measures. The goal: make dignified, palliative care the default, not vegetative survival.
Empower Families, Not Institutions: Shift decision-making power away from litigious hospitals and toward patients and their loved ones. This could mean legal protections for doctors who, in good faith, honor a family’s request for a “dignified end” in hopeless cases, provided it aligns with the patient’s known values. The current fear of lawsuits you describe paralyzes compassion; reducing that fear could restore the quiet agreements of the past without slipping into recklessness.
Guardrails Against Abuse: To counter the Right’s mistrust of the state and the Left’s flippancy, any system must have ironclad safeguards. No assisted dying for mental illness alone (as you reject), no pressure on the “legacy population” to opt out, and no vague “quality of life” loopholes. Transparency—public reporting on cases, anonymized—could build trust and ensure accountability.
This isn’t a perfect solution. It risks offending religious sensibilities, though one could argue that mercy aligns with Christian compassion more than rigid preservation of life does. It might still be too costly or bureaucratic in practice. And it demands a maturity society may lack—facing death head-on rather than hiding behind technology or platitudes. Yet it addresses your core points: it restores dignity, relieves families, curbs financial ruin, and confronts the cruelty of prolonged suffering.
Your ancestors’ hypothetical “final night” suggests they’d lean on community and simplicity—values we’ve lost in our obsession with control. Maybe the real answer lies there: not just in laws or systems, but in rediscovering a shared willingness to let go when the time comes. What do you think—does this strike the balance, or have I missed the mark?'
Disclaimer: Grok is not a lawyer; please consult one. Don't share information that can identify you.
You have a major point here. I may bring in my direct experience with the demise and death of my grand-parents and of their friends.
Some lived into their 90s in relatively decent shape, others declined a lot earlier. All old people had a period where they remained autonomous but needed domestic help in terms of cooking and cleaning the house. This kind of help is easy to procure.
All those who were afflicted by dementia had severe health problems in parallel, which could have killed them : heart attacks, brain strokes, cancers were the most frequent but also diseases afflicting the liver, kidneys, guts, lungs, blood. My conclusion from their suffering is that one should stop treating old people in the stage of limited autonomy and let them meet a decent death then. No real need for euthanasia.
Several obstacles to this solution. First the Christian society taught people to prepare for death: spiritually and materially. My grand-parents and their friends did so, sometimes more than a decade in advance. The notion a good well-prepared death has completely vanished. Second the months of sickness prior to the good death usually were accepted as a hopefully short period of suffering. Suffering and pain are now alien notions. Third big business is behind medicine for Alzheimer and other forms of senile dementia. They want to take that wealth from the middle class. I expect the state and NHS to help them to do so.
So I do not know what to say to people whose relatives are trapped in a care home. Because they lack the basic notions for accepting death.
On a personal note, we made our utmost to prolong the life of my grand-parents: 5 years of zombie life for my grand-mother and 16 months for my grand-father. Each one could have died several times in this period. But my mother was adamant so we paid to "save" them. In retrospect, we regret it. Not for the money. But because my grand-mother stopped being the person we knew and my grand-father turned into a tottering bed-ridden ruin.
Quote: “Anyone suggesting that 21st Century healthcare can be financed by charity, like 19th Century healthcare for the poor was financed, is just wasting everyone’s time.”
Perhaps we should consider that a great deal of expensive 21st Century healthcare is quite useless. As examples of modern medicine a commentator above mentioned statins and heart surgeries - well, some heart surgeries are next to useless and statins are actually poison and may be a cause of Alzheimer’s- the brain needs cholesterol. Perhaps if no one ever again was injected with any vaccine we would all be healthier; perhaps if the government didn’t give ridiculous and damaging advice regarding diet (we are told to eat lots of carbs and hardly any fat) we would all be healthier. Perhaps if they stopped lying about cancer and its causes and actual cures we would all be healthier, ditto heart disease and other chronic diseases. Trauma medicine may have improved - better to be shot or run down by a car nowadays than in previous decades - but doctors are useless when it comes to chronic disease, it causes and cures.
If children were taught how to cook healthy meals, and what a healthy meal actually is (very low carb, high fat) perhaps that would save many from a life of obesity and chronic illness.
So, given all that, what makes you think that medicine has to be so expensive? Why is it so expensive? There are some very fundamental questions regarding health and longevity that need to be answered before we start thinking about euthanasia, not least the fact that modern medicine has gone down a very dark road and ignores many treatments that could cure many of the commons diseases we suffer from - surely ‘Covid’ taught us that. The evil ones certainly want us dead, or chronically sick at least, so our focus should be on what 21st century medicine is doing wrong, not throwing up our hands and deciding just to end it all. Of course we all die, but I truly believe many are dying of illness like cancer and Alzheimer’s that could be cured, or avoided in the first place if we were all better educated regarding diet and alternative medicine, and, of course, the utter uselessness and evil of vaccines and much of the pharmaceutical ‘solutions’ on offer from Rockefeller medicine.
The "very" low carb, high fat diet you recommend is not right for everyone. Biological individuality must be kept in mind. Further, not everyone is able to keep to any sort of restricted diet no matter how theoretically correct it seems to be. It is just too hard for some people. We are not a bunch of lawnmowers where you stick in the right kind of fuel and away you go.
Just remembered, in the appendix to Lord of the Rings, Aragorn is old and ready to die, apparently it is given to him and his kind to simply surrender their life when they are old, by an act of will. His elf wife (who is immortal) pleads with him to stay on the throne, he replies something like, "would you have me rule when I can no longer hold the crown, when I am witless and dotard?" Tolkien was a Catholic so it's interesting to have one of his heroes actually choosing a kind of euthanasia.
I propose something more compassionate, such as rationed healthcare for the elderly depending on their ability to be useful, compos mentis and stay healthy with the minimum of medical attention.
I'm not angry with you for writing this, Woes. But I don't think we can actually be genuinely realistic in our approach to this question without acknowledging that human beings really are fundamentally different sorts of creatures to dogs, and the instinctual revulsion at euthenasia and assisted suicide are not a matter of squeamishness or conditioned ethics, but a natural and good recognition that there is something sacred about human life in particular, because man alone is made in the image of God.
A very scary topic for which people will respond with great emotions.
Beyond religious beliefs, I think some other factors drive the emotional responses from most of the public. How much does the person fear death? How much does the person fear long term suffering without hope of quality recovery? How much does the person fear that the state will abuse their option to end life to dispose of inconvenient cost liabilities? Has the person spent time around the those in end of life care, or witnessed a loved one expire slowly and ungracefully?
For myself personally I think it is important to maintain that vague but important line of not directly killing a patient. Although as you rightly note giving a person on death's door opiates is functionally "easing them along" by suppressing their air hunger reflex. Doing more than that just opens the door to too many ethical problems and bad incentives though.
If you want to really twist your mind, try integrating this ethical debate with the topic of organ transplants. After all those organs need to be very...fresh...to be useful.
These are all potent points, well said. We do have a future crisis on our hands.
Relatives burdened with caring for protracted dementia is grueling enough; how about the vast numbers of childless who'll be aging out? Unintentionally childless myself, and observing my mother's decline, with my brother's weekly care (until some accident that gets her into an ER-- she wont' see a doctor, hence no additional state care), I'm terrified that if I've inherited that gene, I'll be wandering a loose on the city streets with no one to notice. I wonder whether this was the dystopia that feminism prophesied when harping on the idea that "a woman needs a man like a fish needs a bicycle," which for most means no children. Many of the younger generation --I've met some incredibly callous millennial women -- insist that they're better off without kids, so they can save money for long-term care. I find this a rather karmic prospect, given their race and immigration crusades. Picturing them in the long-term care home, being rattled by someone whom they justified despising them for their race....! Regardless, I'm duly concerned about this. It does seem inevitable that the untold numbers of childless will be euthanized, as there doesn't seem to be another....final solution. Sorry to put it that way, but it's going to be a huge problem, which we will need to solve.
Interesting. I've been writing a piece on this very subject. I'm 76, so old enough to put some thought into it. I do think we were better off in the 1940's, 1950s, when people usually checked out fast. "Had did it happen, Aunt Mary?" "Well, Uncle Joe went back to the fridge for another piece of my double chocolate cake and before he could get there, he dropped like a sack of potatoes."
Before Statins, before heart-bypasses, men and women mostly went out via heart attacks. I guess it's somewhat like car repair. You can replace parts, but at some point you can't keep the old heap running anymore.
“As far as I can see, the bottom line is that we have to stop keeping people alive so long in this condition (dementia). There is no way to afford it except by impoverishing ourselves, it is an undignified way to spend one’s last years, it takes a huge emotional toll on relatives and friends, and it destroys inter-generational wealth.”
Hmmm... sending them on their way with a double shot of morphine would be quick and clean. But if we’re going to streamline the way out, we should also monetize the corpse. There’s valuable stuff in there still. Just ask Planned Parenthood. And as for burial… think Waste Management. Those hulking plastic cans on wheels will do the job. Just put some bricks on the lid if you have crows or racoons in the neighborhood. Actually, murderers have already discovered how easy it is to get rid of a body this way. Once it’s buried under 50 feet of compacted trash, it’s too costly to dig up.
Anyway, I think they’re already working on some new and innovative ways to send Uncle Joe on that final trip, like with ‘Green Cremation.’ Young Millennials are down with that because it’s got ‘green’ in the name. Green Cremation essentially digests people in big stainless steel tanks. No heat pollution, no smoke up the chimney. It’s all good. After an hour or so, the machine issues a huge belch and Uncle Joe is drained into the sewar system. But we have to take it a step further and use that green goo for other things—glue, fertilizer, new plastics, biodegradable too. That will greatly reduce the need for landfills.
“I believe that our ancestors, with a tiny fraction of our technological capacity, would be able to come up with something.” (to send Uncle Jo on his way).
Yeah, ten thousand years ago, they weren't as sentimental as we are today. Uncle Jo end up in the tent, some of the young men drumming, the young women doing interpretive dancing, while others cry softly. Then, when everyone falls asleep, Mongo the Mortician goes in with his club. One good one upside the head. Problem solved.
Well, you’ve started the conversation. Let’s see where it goes.
Face your death and walk it with some dignity. Live your death. You have a lifetime to prepare. It doesn't take nearly so long. Fear keeps you captive. Fear keeps you restrained. At the end the fear is useless. It always was.
'I find this rather ironic, considering that people were much more relaxed about “helping someone out the door” when we were much more Christian than we are now.'
That's not quite correct. What happened was shameful and shaming, the parties knew this and that knowledge as well as the legality question, was a reason for the taboo.
The problem with liberalisation of euthanasia as with every other aspect of liberalism is its transactional, reductive nature and tendency to reduce human beings to economic units. It's the failure to recognise our transcendental nature that will eradicate our species not the cost of looking after the elderly.
Doctors just need to stop keeping extremely sick people alive through heroic medicine. They will return to their Creator soon enough. Keeping them reasonably comfortable is all that is needed to be moral in these difficult situations. JMO.
However, there is the little problem of involuntary (or voluntary, too) organ donation. Doctors are apt to hasten you along if some party is waiting, $100,000 in hand, for your liver, kidneys, lungs, eyes, whatever. It is true and it is an industry.
Agree. Not keeping people alive after all hope has evaporated is quite a sensible and humane policy and very different from killing those for whom there is hope and a future.
I think back to the pre-Harold Shipman era, when there was trust that doctors would do 'the right thing.' You could point to Jimmy Savile at Broadmoor, and state that 'a more innocent time' is a myth; but there's a difference between blind trust and implicit trust. The era of family doctors with moral authority who the community knew for decades is mostly over. Even then, with my own run of the mill experiences with 'are NHS', it's such a crapshoot to the care I receive that I think handing out paracetamol to 'gas me now' is too big a leap for me. To respect my dear grandmother's memory I won't go into details but last year she was in hospital and the doctors were wanting to send her back to the house. The routine they'd laid out for her was barely a life. However, she passed in the hospital of a rural NHS branch looked after by local nurses overlooking the Scottish countryside. 'Shortbread tin' aesthetics aside I think that sense of localism and continuity mimicked successfully how death should be treated culturally; around family, familiar setting, and not strange and alien. She'd arrived at her natural end, if she was let out the hospital it wouldn't have been much of a life (don't sit too long, don't stand too long, don't lie in your bed too long, be attached to this or that-- a restrictive and 'artificial' existence). You worry about it for such a long time as you see someone unravel, but when it happens, it happens, nature takes the wheel and somehow guides you through it. When the doctor was telling us about this routine, it felt very 'unnatural', I could feel it intuitively. I don't think she wanted to overstay the welcome, which at the end of the day, is very Scottish granny behaviour. She was one of the greats.
What might interest you is the first chapter of Karl Ove Knausgård's My Struggle (Book 1), where he discusses how society distances itself from death, treating it as a bad thing, concealing it, when it's a part of the life cycle. It's a great chapter and I think it gets to the heart of the matter of how we've culturally severed ourselves from nature, as you mentioned at the end of your essay.
Completely agree. My mum died last year aged 88, suffering from severe dementia and having not got out of bed for the last 5 years. If she could have seen herself she'd have said "Oh, just shoot me."
This could easily be solve by a policy of "Dementia sufferers who have lost the ability to recognise their loved ones should be moved on from this world to the next as unobtrusively as possible eg withholding medical care and being put on a Do Not Strive Officiously To Keep Alive List."
My mom said; "You'd shoot a horse." She went through a lot pain to pass in peace at the end. We do show more compassion to animals than people in many cases.
My dad passed away last month. It was a sudden heart attack and he did not suffer. It's exactly as he would have wished and us 3 kids new that. We even found DNR papers in his desk and vehicles. I thank God that it was not a decision we had to make, to put him in some home or decide to try to keep him alive on the chance he could wake up, but ultimately he always made his wishes clear that he had no desire to remain alive in any situation of significant diminished capacity. I miss him so much, but am thankful for the mercy of his dignified passing and that the state had no say in it.
My condolences. Oddly enough, a very close friend of mine, a man in his mid 70s, also died last month of a sudden heart attack. The loss has been very painful and shocking, but on the other hand I am glad he didn't have to live in a diminished state, because he was the type who very much value self-sufficiency so any loss of independence would have been a torment for him. As morbid and undesirable as death is, I think that is the way most of us would choose to go - sudden and simple.
A very thoughtful and compassionate take.
The DR discourse on euthanasia has for too long been dominated by inverted church morality and conspiritard hysteria.
Great article.
One important question is which generation this concerns.
Somewhere in the mid 1900s Social Security programs were initiated all around the West, where the working class would be taxed in order to give to the elderly. Then, there were very few elderly, but the Boomers followed.
Today in the West it is normal for 40 % of one's income to be taken so that the Boomers can spend it on endless vacation trips. There is no question to be asked, the theft must end along with any further services and the focus must be completely shifted to the new, more responsible generations.
I asked Grok what the solution was after quoting your essay:
'The essay raises profound and challenging questions about end-of-life care, dignity, and societal priorities—issues that are indeed ancient yet newly pressing due to modern medical, legal, and cultural shifts. You’ve laid out a compelling case: the prolongation of life in states of severe suffering or unconsciousness often comes at an unbearable cost to individuals, families, and society. You’ve also highlighted the tension between idealism and realism, the squeamishness that stifles discussion, and the moral complexities that defy easy answers. So, what’s the solution?
There’s no single, tidy fix—any approach will involve trade-offs and discomfort—but a framework can be imagined that balances compassion, autonomy, and pragmatism while guarding against abuse. Here’s a possible path forward, grounded in the concerns you’ve raised:
Legalize Assisted Dying with Strict, Narrow Criteria: Establish a legal mechanism for hastening death, but limit it to cases of terminal illness or irreversible degenerative conditions (e.g., advanced dementia, ALS) where suffering is demonstrable and recovery impossible. This would require clear evidence of the patient’s prior wishes—ideally through a living will or advance directive made when they were of sound mind—and the unanimous consent of immediate family or designated proxies. The process would involve multiple medical and ethical reviews to ensure no coercion or haste, addressing your valid mistrust of state overreach and the Canadian-style trivialization of death.
Shift Cultural Norms Around Death: Encourage a societal reorientation toward accepting mortality as natural, not something to be resisted at all costs. This could mean reviving or creating rituals—like your “final night” idea—where death is framed as a communal, dignified passage rather than a sterile, medicalized ordeal. Education campaigns could normalize advance care planning, reducing the taboo around discussing end-of-life preferences and easing the burden on families when decisions arise.
Reform Care Funding and Incentives: Address the financial absurdity of prolonged care by capping costs or subsidizing them in a way that doesn’t bankrupt families, while removing profit motives from private care homes. Nationalization might be impractical, as you note, but a hybrid system—publicly funded baselines with private options—could work if paired with regulations that penalize unnecessary life-prolonging measures. The goal: make dignified, palliative care the default, not vegetative survival.
Empower Families, Not Institutions: Shift decision-making power away from litigious hospitals and toward patients and their loved ones. This could mean legal protections for doctors who, in good faith, honor a family’s request for a “dignified end” in hopeless cases, provided it aligns with the patient’s known values. The current fear of lawsuits you describe paralyzes compassion; reducing that fear could restore the quiet agreements of the past without slipping into recklessness.
Guardrails Against Abuse: To counter the Right’s mistrust of the state and the Left’s flippancy, any system must have ironclad safeguards. No assisted dying for mental illness alone (as you reject), no pressure on the “legacy population” to opt out, and no vague “quality of life” loopholes. Transparency—public reporting on cases, anonymized—could build trust and ensure accountability.
This isn’t a perfect solution. It risks offending religious sensibilities, though one could argue that mercy aligns with Christian compassion more than rigid preservation of life does. It might still be too costly or bureaucratic in practice. And it demands a maturity society may lack—facing death head-on rather than hiding behind technology or platitudes. Yet it addresses your core points: it restores dignity, relieves families, curbs financial ruin, and confronts the cruelty of prolonged suffering.
Your ancestors’ hypothetical “final night” suggests they’d lean on community and simplicity—values we’ve lost in our obsession with control. Maybe the real answer lies there: not just in laws or systems, but in rediscovering a shared willingness to let go when the time comes. What do you think—does this strike the balance, or have I missed the mark?'
Disclaimer: Grok is not a lawyer; please consult one. Don't share information that can identify you.
You have a major point here. I may bring in my direct experience with the demise and death of my grand-parents and of their friends.
Some lived into their 90s in relatively decent shape, others declined a lot earlier. All old people had a period where they remained autonomous but needed domestic help in terms of cooking and cleaning the house. This kind of help is easy to procure.
All those who were afflicted by dementia had severe health problems in parallel, which could have killed them : heart attacks, brain strokes, cancers were the most frequent but also diseases afflicting the liver, kidneys, guts, lungs, blood. My conclusion from their suffering is that one should stop treating old people in the stage of limited autonomy and let them meet a decent death then. No real need for euthanasia.
Several obstacles to this solution. First the Christian society taught people to prepare for death: spiritually and materially. My grand-parents and their friends did so, sometimes more than a decade in advance. The notion a good well-prepared death has completely vanished. Second the months of sickness prior to the good death usually were accepted as a hopefully short period of suffering. Suffering and pain are now alien notions. Third big business is behind medicine for Alzheimer and other forms of senile dementia. They want to take that wealth from the middle class. I expect the state and NHS to help them to do so.
So I do not know what to say to people whose relatives are trapped in a care home. Because they lack the basic notions for accepting death.
On a personal note, we made our utmost to prolong the life of my grand-parents: 5 years of zombie life for my grand-mother and 16 months for my grand-father. Each one could have died several times in this period. But my mother was adamant so we paid to "save" them. In retrospect, we regret it. Not for the money. But because my grand-mother stopped being the person we knew and my grand-father turned into a tottering bed-ridden ruin.
Quote: “Anyone suggesting that 21st Century healthcare can be financed by charity, like 19th Century healthcare for the poor was financed, is just wasting everyone’s time.”
Perhaps we should consider that a great deal of expensive 21st Century healthcare is quite useless. As examples of modern medicine a commentator above mentioned statins and heart surgeries - well, some heart surgeries are next to useless and statins are actually poison and may be a cause of Alzheimer’s- the brain needs cholesterol. Perhaps if no one ever again was injected with any vaccine we would all be healthier; perhaps if the government didn’t give ridiculous and damaging advice regarding diet (we are told to eat lots of carbs and hardly any fat) we would all be healthier. Perhaps if they stopped lying about cancer and its causes and actual cures we would all be healthier, ditto heart disease and other chronic diseases. Trauma medicine may have improved - better to be shot or run down by a car nowadays than in previous decades - but doctors are useless when it comes to chronic disease, it causes and cures.
If children were taught how to cook healthy meals, and what a healthy meal actually is (very low carb, high fat) perhaps that would save many from a life of obesity and chronic illness.
So, given all that, what makes you think that medicine has to be so expensive? Why is it so expensive? There are some very fundamental questions regarding health and longevity that need to be answered before we start thinking about euthanasia, not least the fact that modern medicine has gone down a very dark road and ignores many treatments that could cure many of the commons diseases we suffer from - surely ‘Covid’ taught us that. The evil ones certainly want us dead, or chronically sick at least, so our focus should be on what 21st century medicine is doing wrong, not throwing up our hands and deciding just to end it all. Of course we all die, but I truly believe many are dying of illness like cancer and Alzheimer’s that could be cured, or avoided in the first place if we were all better educated regarding diet and alternative medicine, and, of course, the utter uselessness and evil of vaccines and much of the pharmaceutical ‘solutions’ on offer from Rockefeller medicine.
The "very" low carb, high fat diet you recommend is not right for everyone. Biological individuality must be kept in mind. Further, not everyone is able to keep to any sort of restricted diet no matter how theoretically correct it seems to be. It is just too hard for some people. We are not a bunch of lawnmowers where you stick in the right kind of fuel and away you go.
Just remembered, in the appendix to Lord of the Rings, Aragorn is old and ready to die, apparently it is given to him and his kind to simply surrender their life when they are old, by an act of will. His elf wife (who is immortal) pleads with him to stay on the throne, he replies something like, "would you have me rule when I can no longer hold the crown, when I am witless and dotard?" Tolkien was a Catholic so it's interesting to have one of his heroes actually choosing a kind of euthanasia.
https://alt-death.com/2020/06/11/the-thanatorium-of-soylent-green/ tells us how the helpless, unproductive and superfluous elderly will probably be dealt with in the future.
I propose something more compassionate, such as rationed healthcare for the elderly depending on their ability to be useful, compos mentis and stay healthy with the minimum of medical attention.
I'm not angry with you for writing this, Woes. But I don't think we can actually be genuinely realistic in our approach to this question without acknowledging that human beings really are fundamentally different sorts of creatures to dogs, and the instinctual revulsion at euthenasia and assisted suicide are not a matter of squeamishness or conditioned ethics, but a natural and good recognition that there is something sacred about human life in particular, because man alone is made in the image of God.
A very scary topic for which people will respond with great emotions.
Beyond religious beliefs, I think some other factors drive the emotional responses from most of the public. How much does the person fear death? How much does the person fear long term suffering without hope of quality recovery? How much does the person fear that the state will abuse their option to end life to dispose of inconvenient cost liabilities? Has the person spent time around the those in end of life care, or witnessed a loved one expire slowly and ungracefully?
For myself personally I think it is important to maintain that vague but important line of not directly killing a patient. Although as you rightly note giving a person on death's door opiates is functionally "easing them along" by suppressing their air hunger reflex. Doing more than that just opens the door to too many ethical problems and bad incentives though.
If you want to really twist your mind, try integrating this ethical debate with the topic of organ transplants. After all those organs need to be very...fresh...to be useful.
These are all potent points, well said. We do have a future crisis on our hands.
Relatives burdened with caring for protracted dementia is grueling enough; how about the vast numbers of childless who'll be aging out? Unintentionally childless myself, and observing my mother's decline, with my brother's weekly care (until some accident that gets her into an ER-- she wont' see a doctor, hence no additional state care), I'm terrified that if I've inherited that gene, I'll be wandering a loose on the city streets with no one to notice. I wonder whether this was the dystopia that feminism prophesied when harping on the idea that "a woman needs a man like a fish needs a bicycle," which for most means no children. Many of the younger generation --I've met some incredibly callous millennial women -- insist that they're better off without kids, so they can save money for long-term care. I find this a rather karmic prospect, given their race and immigration crusades. Picturing them in the long-term care home, being rattled by someone whom they justified despising them for their race....! Regardless, I'm duly concerned about this. It does seem inevitable that the untold numbers of childless will be euthanized, as there doesn't seem to be another....final solution. Sorry to put it that way, but it's going to be a huge problem, which we will need to solve.
Interesting. I've been writing a piece on this very subject. I'm 76, so old enough to put some thought into it. I do think we were better off in the 1940's, 1950s, when people usually checked out fast. "Had did it happen, Aunt Mary?" "Well, Uncle Joe went back to the fridge for another piece of my double chocolate cake and before he could get there, he dropped like a sack of potatoes."
Before Statins, before heart-bypasses, men and women mostly went out via heart attacks. I guess it's somewhat like car repair. You can replace parts, but at some point you can't keep the old heap running anymore.
“As far as I can see, the bottom line is that we have to stop keeping people alive so long in this condition (dementia). There is no way to afford it except by impoverishing ourselves, it is an undignified way to spend one’s last years, it takes a huge emotional toll on relatives and friends, and it destroys inter-generational wealth.”
Hmmm... sending them on their way with a double shot of morphine would be quick and clean. But if we’re going to streamline the way out, we should also monetize the corpse. There’s valuable stuff in there still. Just ask Planned Parenthood. And as for burial… think Waste Management. Those hulking plastic cans on wheels will do the job. Just put some bricks on the lid if you have crows or racoons in the neighborhood. Actually, murderers have already discovered how easy it is to get rid of a body this way. Once it’s buried under 50 feet of compacted trash, it’s too costly to dig up.
Anyway, I think they’re already working on some new and innovative ways to send Uncle Joe on that final trip, like with ‘Green Cremation.’ Young Millennials are down with that because it’s got ‘green’ in the name. Green Cremation essentially digests people in big stainless steel tanks. No heat pollution, no smoke up the chimney. It’s all good. After an hour or so, the machine issues a huge belch and Uncle Joe is drained into the sewar system. But we have to take it a step further and use that green goo for other things—glue, fertilizer, new plastics, biodegradable too. That will greatly reduce the need for landfills.
“I believe that our ancestors, with a tiny fraction of our technological capacity, would be able to come up with something.” (to send Uncle Jo on his way).
Yeah, ten thousand years ago, they weren't as sentimental as we are today. Uncle Jo end up in the tent, some of the young men drumming, the young women doing interpretive dancing, while others cry softly. Then, when everyone falls asleep, Mongo the Mortician goes in with his club. One good one upside the head. Problem solved.
Well, you’ve started the conversation. Let’s see where it goes.
Face your death and walk it with some dignity. Live your death. You have a lifetime to prepare. It doesn't take nearly so long. Fear keeps you captive. Fear keeps you restrained. At the end the fear is useless. It always was.
'I find this rather ironic, considering that people were much more relaxed about “helping someone out the door” when we were much more Christian than we are now.'
That's not quite correct. What happened was shameful and shaming, the parties knew this and that knowledge as well as the legality question, was a reason for the taboo.
The problem with liberalisation of euthanasia as with every other aspect of liberalism is its transactional, reductive nature and tendency to reduce human beings to economic units. It's the failure to recognise our transcendental nature that will eradicate our species not the cost of looking after the elderly.
Doctors just need to stop keeping extremely sick people alive through heroic medicine. They will return to their Creator soon enough. Keeping them reasonably comfortable is all that is needed to be moral in these difficult situations. JMO.
However, there is the little problem of involuntary (or voluntary, too) organ donation. Doctors are apt to hasten you along if some party is waiting, $100,000 in hand, for your liver, kidneys, lungs, eyes, whatever. It is true and it is an industry.
Agree. Not keeping people alive after all hope has evaporated is quite a sensible and humane policy and very different from killing those for whom there is hope and a future.
Thanks, JK. I can't upvote you because of this elderly computer I'm using. My son said I could have his (he built it) but who knows when...
I think back to the pre-Harold Shipman era, when there was trust that doctors would do 'the right thing.' You could point to Jimmy Savile at Broadmoor, and state that 'a more innocent time' is a myth; but there's a difference between blind trust and implicit trust. The era of family doctors with moral authority who the community knew for decades is mostly over. Even then, with my own run of the mill experiences with 'are NHS', it's such a crapshoot to the care I receive that I think handing out paracetamol to 'gas me now' is too big a leap for me. To respect my dear grandmother's memory I won't go into details but last year she was in hospital and the doctors were wanting to send her back to the house. The routine they'd laid out for her was barely a life. However, she passed in the hospital of a rural NHS branch looked after by local nurses overlooking the Scottish countryside. 'Shortbread tin' aesthetics aside I think that sense of localism and continuity mimicked successfully how death should be treated culturally; around family, familiar setting, and not strange and alien. She'd arrived at her natural end, if she was let out the hospital it wouldn't have been much of a life (don't sit too long, don't stand too long, don't lie in your bed too long, be attached to this or that-- a restrictive and 'artificial' existence). You worry about it for such a long time as you see someone unravel, but when it happens, it happens, nature takes the wheel and somehow guides you through it. When the doctor was telling us about this routine, it felt very 'unnatural', I could feel it intuitively. I don't think she wanted to overstay the welcome, which at the end of the day, is very Scottish granny behaviour. She was one of the greats.
What might interest you is the first chapter of Karl Ove Knausgård's My Struggle (Book 1), where he discusses how society distances itself from death, treating it as a bad thing, concealing it, when it's a part of the life cycle. It's a great chapter and I think it gets to the heart of the matter of how we've culturally severed ourselves from nature, as you mentioned at the end of your essay.
Completely agree. My mum died last year aged 88, suffering from severe dementia and having not got out of bed for the last 5 years. If she could have seen herself she'd have said "Oh, just shoot me."
This could easily be solve by a policy of "Dementia sufferers who have lost the ability to recognise their loved ones should be moved on from this world to the next as unobtrusively as possible eg withholding medical care and being put on a Do Not Strive Officiously To Keep Alive List."
The Latest Decalogue by A H Clough
Thou shalt have one God only; who
Would tax himself to worship two?
God's image nowhere shalt thou see,
Save haply in the currency:
Swear not at all; since for thy curse
Thine enemy is not the worse:
At church on Sunday to attend
Will help to keep the world thy friend:
Honor thy parents; that is, all
From whom promotion may befall:
Thou shalt not kill; but needst not strive
Officiously to keep alive:
Adultery it is not fit
Or safe, for women, to commit:
Thou shalt not steal; an empty feat,
When 'tis so lucrative to cheat:
False witness not to bear be strict;
And cautious, ere you contradict.
Thou shalt not covet; but tradition
Sanctions the keenest competition.
https://allpoetry.com/The-Latest-Decalogue
My mom said; "You'd shoot a horse." She went through a lot pain to pass in peace at the end. We do show more compassion to animals than people in many cases.
My dad passed away last month. It was a sudden heart attack and he did not suffer. It's exactly as he would have wished and us 3 kids new that. We even found DNR papers in his desk and vehicles. I thank God that it was not a decision we had to make, to put him in some home or decide to try to keep him alive on the chance he could wake up, but ultimately he always made his wishes clear that he had no desire to remain alive in any situation of significant diminished capacity. I miss him so much, but am thankful for the mercy of his dignified passing and that the state had no say in it.
My condolences. Oddly enough, a very close friend of mine, a man in his mid 70s, also died last month of a sudden heart attack. The loss has been very painful and shocking, but on the other hand I am glad he didn't have to live in a diminished state, because he was the type who very much value self-sufficiency so any loss of independence would have been a torment for him. As morbid and undesirable as death is, I think that is the way most of us would choose to go - sudden and simple.