The title of this column could be a lead-in to a story about how some miracle of modern medicine kept me alive after I contracted a disease which would, only a few years ago, have killed me. But my intention in this essay is not to recognize, and express gratitude for, the accomplishments of medical science; it's quite the opposite: it's to raise questions about the desirability of just those accomplishments. The thesis of this column is that people are living too long these days, and their right to die when they choose is insufficiently honored
The common assumption is that "to be" is always better than "not to be." That is simply not the case. Suicide statistics surely suggest that, but the common view of suicide - especially the suicide of young people -- is that it's the product of mental illness, and should, therefore, be prevented by timely psychiatric treatment. I do not entirely disagree with this view, for teens are, indeed, subject to exaggerated but temporary feelings of despair, but that mustn't be taken to mean that a wish to end one's life is always irrational.
Another attitude about suicide is that it is morally wrong because God alone has the right to end someone's life, and, moreover, suicide violates the commandment "Thou shalt not kill." Christians have traditionally regarded suicide as a mortal sin, but in 1992, the Catholic Church adopted the more moderate view that those who kill themselves have not necessarily deprived themselves of salvation. An uncomfortable awkwardness of Christian opposition to suicide is that Christian martyrs and Christ himself could plausibly be said to have committed suicide, yet they can hardly be accused of sinning in doing so.
My claim that people are living too long rests, in part, upon the fact that medical advances have made possible a steady increase in the average human lifespan. Life expectancy in this country is now age 78, which means, of course, that many of us live considerably longer than that, and as a result, a great many elderly people live long enough to experience the full debilitating and dispiriting effects of the aging process. I don't deny that modern medicine and technology have compensated for some of aging's
destructive consequences, but even cataract surgery and the latest self-propelled wheelchair don't return us to our youth, or even middle-age.
The general public has, over the past year, heard a great deal about aging issues in connection with our presidential campaigns. Those two old people, Joe Biden and Donald Trump, have received exhaustive coverage in the press precisely because of the evidence that they both exhibit a loss of competence caused by aging. In their cases, attention has been focused upon their loss of mental acuity. They both seem to have an increased inability to construct coherent arguments, finish thoughts and remember facts accurately. Admittedly, Trump's performance is affected by his other psychological problems, but the testimony of those who have observed his behavior over the past few years confirms age-caused decline as well.
To those of us who are as old or older than Biden and Trump, the symptoms of aging that they display are quite familiar. We therefore see those symptoms not just as evidence of that pair's growing incompetence to carry out the duties of the presidency, but as part of our own struggles to cope with our diminishing capacities.
There's no great mystery about the effects of aging. Muscles shrink, strength ebbs, senses decay, ailments multiply, memories fade, energy diminishes. Tasks that before were performed with no noticeable effort, now require rest periods. The immune system weakens, creating a greater susceptibility to health problems, and recovery from those problems is more difficult and takes longer. Underlying these symptoms are numerous pathological changes at the level of genomes and cells.
I don't mean to suggest that the pattern of aging is the same for everyone. Some people show little loss of mental acuity into their nineties; others slide into mental weakness much sooner. But, on the whole, the loss of skills, endurance and wellbeing is inexorable, and the future no longer spreads out before you as a realm of opportunity and achievement; it holds no promise except of a deepening of discomfort, inconvenience and incompetence.
Like other animals, we have a strong instinct to stay alive. But, unlike other animals, we can see the future. Even the medical profession, which many insist has the sole aim of preserving life (and hence cannot engage in assisted suicide) has recognized that circumstances may call upon it to
betray its Hippocratic Oath. It is now commonplace for living wills to give people the option of refusing to allow certain measures to be taken to preserve their lives - a clear acknowledgment by the profession that staying alive may not be preferable to death.
In this column, I've stressed the effects of an excessive prolongation of life upon those who experience it, but I'm well aware that the consequences of advanced aging extend far beyond that.
Whole countries find themselves facing an increasingly elderly population plus a diminishing birth rate, with the result that fewer and fewer working citizens are available to support those who have retired.
On the social and family fronts, the longer people live, the more likely they are to experience physical and/or mental deterioration that renders them unable to cope with everyday tasks. Who, then, will care for them? If an elderly person has several children, which one will take on the burden of that care, and the costs associated with it? Consider, as well, the cost to the nation of providing medical care for those aged who, in effect, have become disabled.
What about the laws governing assisted suicide? Only 11 states have laws permitting it, but all of them require someone to have a terminal illness with less than six months of expected life to qualify for treatment. Does that really acknowledge that the old have a right to end their lives?
And, in this country, as in most others, only a citizen who has attained a certain minimum age, can engage in certain activities, e.g. drive a car, vote in an election, get married. It's assumed that reaching that minimal age provides some assurance of competency and trustworthiness. Are we approaching a time when government, to acquire that same assurance, will impose a maximum age limit, as well?