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Hate speech against the elderly

"Hate speech" is not a phrase I use often. I want to go on record that I'm not suggesting that such speech be proscribed by law. But there is a particular feeling of revulsion that that over-used phrase is meant to evoke, and in this case, I consider that feeling of revulsion amply justified.

Here is the rather shocking quotation, from novelist Martin Amis:

“Medical science has again over-vaulted itself,” he says now, “so most of us have to live through the death of our talent. Novelists tend to go off at about 70. And I’m in a funk about it. I’ve got myself into a real paranoid funk about it, how talent dies before the body.”

...He is disgusted at the problem of the ageing [sic] population: “How is society going to support this silver tsunami? There’ll be a population of demented very old people, like an invasion of terrible immigrants, stinking out the restaurants and cafes and shops. I can imagine a sort of civil war between the old and the young in 10 or 15 years’ time.”

Amis’s solution is typically extreme: mass euthanasia. “There should be a booth on every corner where you could get a Martini and a medal,” he says. In fact, he was thinking about it only last year, when his stepfather died “very horribly”, he says. “He thought he was going to get better. But he didn’t. I think the denial of death is a great curse. We all wanted to assist him… It was clearly a lost battle.”

That's the whole of the relevant quotation, so I advise readers not to bother going to the article. I, for one, saw far more information there about Martin Amis than I ever wanted to know.

And to be fair, if that is the right word, Amis doesn't always restrict his insults to people like the elderly who can't fight back. He has also kept up his bad boy, tough guy reputation by insulting Muslims, which I suppose one could say is "brave" in the contemporary UK. I'm surprised he hasn't been visited by the police for that, or by a group of people more dangerous than the police, though I have no expectation that he will be visited by anyone or even chided by anyone for the above undeniable hate speech about the elderly. Then again, he doesn't appear to have advocated that all Muslims be killed systematically in booths on street corners. But evidently advocating killing an entire group of innocent people isn't going too far if it's the elderly we're talking about, especially those with (shudder) dementia.

Amis's irrationality is pretty evident here. We could start with the fact that there is no need for medical science to "overvault itself" for people to live past the height of their talent. In many professions (think sports), people would have to die somewhere between the ages of 30 and 50 in order not to suffer the supposedly dreadful fate of--at least in some significant sense--outliving their talent. And even if we take Amis's mention of seventy, is it really true that most or all people over the age of seventy are being kept alive by a plethora of beeping machines? No, there are plenty of elderly people who get along just fine with decent living conditions, decent nutrition, and some help around the house and with the shopping. Amis's gesture in the direction of the supposed overvaulting of medical science is a smokescreen, a red herring, a deliberate introduction of the specter of wild and extraordinary medical means before he hits us with what he really thinks--his truly hateful desire to see elderly people killed off en masse. It isn't merely complex interventions of medical science Amis wants to deny the elderly--especially the demented elderly. It's anything at all. It's love, care, and even the right to life.

Wesley J. Smith comments perceptively on Amis's evident self-hatred here, something I have noticed myself before in the right-to-die crowd. They look ahead and imagine themselves in a particular state, they feel disgusted at that hypothetical future self, and they want him killed. Love is nowhere in the picture. Or, to put it differently, love and death have become so intertwined that the only way they can imagine expressing love to such a person is by killing him. Says Smith,

In this sense, we need to demonstrate true compassion—the root meaning of which is to “suffer with”—by fully engaging our neighbors’ most trying trials and tribulations. We see that tonic administered all the time—in the selfless care of a daughter for her Alzheimer’s stricken mother and in the hospice volunteer confronting his own mortality by engaging profoundly with dying strangers. Love is what motivates the good people who bring dogs and cats into nursing homes to brighten the day of residents and is the ultimate motivation of the pain-control physician who burns the midnight oil seeking a solution to an intractable case—even though it is work for which she will never be paid.

There will always be the Martin Amises of the world raging in despair against life’s vicissitudes. But they will be rendered societally impotent if each of us loves actively. As St. Paul put it so eloquently, love “bears all things, believes all things, hopes all things, endures all things. Love never fails.” In the end, if we want to finally defeat euthanasia, it will have to be so with us.

I cannot help wondering if Amis's cruel and hateful words about the elderly are becoming acceptable in the UK. Or in the United States. At a minimum, if we hear such talk around us, we should let others know that it is totally unacceptable, even when it is couched in somewhat more genteel terms and even when the "remedies" actually proposed (however vaguely) are less extreme than Amis's:

A world in which increasingly many human beings are without affectionate relations with their kind, persisting as burdens to be carried rather than companions to be enjoyed, will be a world in which human life seems far less precious than it seems to us today....Old people will be regarded increasingly as a nuisance. Moreover, because their [old people's] numbers will be growing and their legal rights will be in no way diminished by their decrepitude, they will soon be majority shareholders in all private and most public goods. They will be sitting on the collective assets of mankind, preventing the young from owning them, and maybe waving their wills in the face of their heirs, in the hope of attracting attention.
We need to recognize the value of timely death and the futility of living beyond the point where anyone will mourn our passing....The critical question is longevity itself, which has brought about a situation in which we all have something to fear worse than death, namely the living death of the loveless.
The habit of timely death might then become engrained, and love restored between the elderly who possess the world and their progeny anxious for a share in it.

Love of the elderly should never be conditional on their dying soon enough and passing on their worldly goods to others. If the elderly are lonely and unloved, the problem lies with those who abandon and refuse to love them, not with their longevity. To call them "the loveless," to refer to their lives as mere "persisting," as a "living death," and to them as "burdens" because they are no longer "companions to be enjoyed" (as though their value depended on the enjoyment others get out of them) is unacceptable.

Amis's hate speech shocks because it is so frank and his final solution so harsh. But the attitudes it enshrines can be found in people who would not say what Amis says and who do not go as far as he goes in their recommendations. And those attitudes are beyond the pale. Let us stand for life and hold the line against them even, indeed especially, if we should find ourselves called to love amidst a graying population.

Comments (63)

Amis' comments surprise me, especially after reading his excellent Koba the Dread, in which he mercilessly excoriates his friend Christopher Hitchens for supporting Stalin and the reign of unthinkable evil.

The problem here, I suppose, is that I'm expecting consistency from a contrarian. Contrarians don't really operate on consistent principle; they're just against something -- almost always the consensus. But given the nature of contemporary consensus, that's often a good thing. Not this time.

I actually find Scruton's remarks more horrifying than Amis's. The latter's merely a shallow, loudmouthed, insouciant twerp, whatever his age. But Scruton reputedly has gravitas. To imagine that love can possibly be the just reward for agreeing to die on schedule is morally deranged.

"The living death of the loveless," btw, is infelicitous, implying that the elderly have lost the capacity for it (love), when in fact they have plenty to offer. Perhaps he meant "unloved", which puts the onus where it belongs. And maybe he meant 'living hell', since it's not death until you're dead.

Well you can't say Amis is behind the times.
The larger issue is who else gets the expendability treatment?
Strange the progress should bring with it open declarations of who is entitled to live, from those assuming the entitlement. The deaths of the unwanted was in the past at least predicated on the needs and poverty of those otherwise responsible, the family.

Progress now gives us detachment, public sanction and discussion, and organizational tools for disposal of humans of questionable value.
I wonder how wide the net will be cast, and in what subtle ways.

~~Perhaps he meant "unloved", which puts the onus where it belongs.~~

From the context this would seem to be the case.

~~And maybe he meant 'living hell', since it's not death until you're dead.~~

"The living dead" and "living death" are fairly common figures of speech. I wouldn't overanalyze them.

Scruton's point, I believe, is different from Amis's. The former seems to me to be saying that longevity in and of itself is not necessarily a good thing. The notion of "timely death" is an old and respectable one, but it has been lost by modern medicine's quest to keep people alive as long as possible, no matter what. Now I don't believe that euthansia or anything of the sort is the correct response to this loss, or should be an approach to its rectification, and if that's what Scruton's saying, I'd disagree. But I would agree with his call for the habit of timely death to be RE-engrained, but in a bottom-up as opposed to a top-down manner. We certainly don't want the government doing any sort of "education" on something like this.


It's actually to my mind quite significant that Scruton used "loveless" when he clearly meant "unloved." Think how differently the sentence would have read with the other word! Let's face it: Scruton's language is very negative towards elderly people who live "too long." How childish, in my opinion, are his repeated references to the wealth of the elderly and their failure to die and pass it on. Not to say creepy. How adolescent and unkind is the image out of nowhere of the elderly ("maybe") waving their wills in the faces of the young. Oh, yah, I know _lots_ of elderly people who do that all the time.

Moreover, Scruton ignorantly appears to believe (as do too many people) that people would die at the time they think people "should" die if only it weren't for medically inappropriate and excessive interventions. To which I say balderdash. It is perfectly possible to live a long life--long enough, I fancy, for Scruton and others to get impatient for one to die and leave the "collective assets of mankind" to the young--without anything extreme being done. Indeed, Scruton repeatedly refers to _medicine_ (which, in some of the sentences, clearly seems to mean not the general practice of medicine but mere medication) as something that extends life too long. This seems to imply that the elderly should not be given medications as that would interfere with "timely death."

Scruton's proposal, Rob G, which has since been expressly adopted in the UK (as I have blogged elsewhere) is that people be permitted to make deliberate, life-taking overdoses of medication available to the elderly so that they can commit suicide. He proposes that the law against assisted suicide be left on the books but that it be evacuated of legal force in these cases by refusal to prosecute those who do this.

The irony is that plenty of elderly people will still live to the point of being lonely and "without affectionate relations with their kind" even if this plan is adopted. Not everybody wants to commit suicide. This is all the more true as Scruton confusedly implies that his plan would only come into effect when a person was already dying, which would restrict it still further if such restrictions ever meant anything in practice. But perhaps we could just declare everyone over seventy to be "dying"? That would simplify matters, anyway.

No, Scruton is definitely portraying a negative picture of longevity per se. He is unwilling or unable to grapple with the fact that longevity can be the result of _ordinary_ medical treatment combined with the good conditions of life in first-world countries. Grappling with that would force him to realize that, as in the case of Amis's comment, all the talk about medical over-reach is a red herring. Scruton wants a world in which people don't bother others and cease to be "companions" by living "too long." He wants a world without Amis's "silver tsunami." He can't get this just by, say, not permitting kidney dialysis or open-heart surgery to the elderly. Something more radical and dark will be required for his ideal of "timely death" to be instantiated.

Which, in my opinion, calls the idyllic nature of that ideal into question.

And as I said above, if that is what Scruton's getting at, I strongly disagree with him in that regard. I do not, however, disagree at all with his view that the idea of longevity for longevity's sake is problematic, and that it is the default mode for much of modern medicine. In that sense it is no red herring.

"longevity can be the result of _ordinary_ medical treatment combined with the good conditions of life in first-world countries."

Well of course it can -- only an idiot would say otherwise. But it's not the healthy elderly we're talking about, is it? It's not Grandpa who lives a long, active life to age 86, when he dies at home peacefully in his sleep, who's at issue. It's the poor old guy who's dying a long, slow death from some wasting illness, but is being kept alive by drugs and machines just for longevity's sake. A friend of mine's father had multiple myeloma for many years and would receive chemo once a month. Eventually, it got to the point as he got older that the chemo wasn't doing anything anymore. He and his family decided that he would stop the chemo, go into in-home hospice and receive palliative care only. I don't remember exactly how long he lived after the chemo stopped, but my friend says that that was the best thing they could have done -- he died at home, comfortably (at least as much as was possible) with his family, where they were all able to say goodbye to each other.

If this is what Scruton means by "timely death" I'm with him. Better to go that way, if possible, than in a hospital bed full of tubes and wires.

@johnt
I know three things that will be used to decide who gets killed. One is being used even now, in some places. They are:
1. Too young
2. Too old
3. Low IQ

There would have been "ethnicity" but recent history seems to have inoculated these societies against it; it would have been the very first on the list.

Rob G, I still think you are trying to read the quotations too charitably and in so doing are missing an obvious meaning. Don't you see where he keeps talking about *sheer length of life* as a problem? And loneliness? Sure, he'll talk about (if you read the whole chapter) people who are dying and their deaths being dragged out, etc., etc. But I believe he is confused and is mixing things that have little or nothing to do with each other. Because in the quotations I give above, what he's concerned with re. timeliness is a) being lonely, b) making your heirs wait to inherit and "sitting on" the assets, and c) not being a "companion to be enjoyed" anymore. _All_ of these are related just to being elderly. The third is presumably related to dementia. _None_ of these has anything in particular to do with taking chemo when one could go to palliative care, etc., nor even with being in an active dying process at all. _All_ of them could apply, yes, to Grandpa who is physically healthy but whose relatives all live far away, have died, or don't have time for him. "Timeliness" in these quotations has to do with *dying soon enough* before these evils befall--evils which are not a matter of being kept alive by machines, taking chemo, or anything of the sort.

As I've said, it's Scruton who thinks he'll solve the one set of problems by curbing the aspirations of medical science. He couldn't be more wrong. Just look around you. Look at any nursing home.

And quite frankly, when we start assuming that the two are connected, the temptation to think of ordinary care and minimal treatments (like, say, food and water or antibiotics for a UTI) as part of this medical overreach becomes overwhelming. If only lonely old Grandpa, sitting on the assets of mankind, persisting beyond affectionate relations with his kind, would die. Hey, he has a UTI. Well, let's not treat him. He's lived out his time. Timely death and all that...

And these attitudes and actions, to the point of dehydrating people to death, are also very widespread.

27th comrade, scratch your # 3. Were it to stand there wouldn't be enough slaughter houses in America to handle the load, the streets would be desolate, and who would have their eardrums shattered while viewing Avatar?
Write in, "too expensive", the price mechanism still prevails as a measure of value.

Lydia, I think you're reading Scruton too critically (I won't say uncharitably), but that's not a point I want to argue. My agreement with him is on the idea that "sheer length of life" is problematic, when that longevity is manufactured/artificial. I see no good in keeping people alive just to keep them alive, which seems to be the m.o. of much modern medicine (due, IMO, to a modern godless fear and, thus, misunderstanding of death).

I strongly reject any notions of euthanasia, withholding ordinary care, etc. As I said above, if that is what Scruton's on about, I disagree with him. But I don't see where an acceptance of the idea of natural "timely" death necessarily leads to euthanasiac views/practices.

Rob G, my whole point is that "natural" death (to the extent that can be defined) is often not "timely" death in the sense of the person's not living such a long time that he is lonely, unloved, and no longer companionable. The two are just not terribly well-correlated, and the assumption that they should be or must be leads to the assumption that anyone really old, really lonely, and even senile must be being "kept alive" in some "unnatural" way.

Lydia,

Two initial quick comments:

First, I can see why Amis is a novelist - "silver tsunami" is a great turn of phrase.

Second, he is also (likely) more prophetic than he intends, or moreso than we'd like him to be. His prediction of an inter-generational war might not be so far off. Does he realize he might be setting himself up as the poet laureate of the younger generation in that war?

Kamilla

In that case, Kamilla, he will be something rather like a poet laureate of the Nazis in the Holocaust. He is, after all, the guy _recommending_ (not simply predicting) death booths on every street corner for the elderly, so they don't "stink out the restaurants and coffee shops." Being able to turn phrases well won't get him far when he meets God.

With all of which I'm sure you agree.

I guess one thing I need to make clear, Rob G., is that I consider nearly everything that Scruton says in the quotations I give here to be entirely inappropriate. It's entirely inappropriate to talk about timely death in connection with people's being "without affectionate relations with their kind" "persisting as burdens to be carried rather than companions to be enjoyed" and "sitting on the collective assets of mankind." The notion of timely death should not be connected with those issues at all. Not at all. This sentence is particularly clear, and particularly wrong-headed:

We need to recognize the value of timely death and the futility of living beyond the point where anyone will mourn our passing.

No, no, no, no, no. How long you should live has nothing to do with whether you are living "beyond the point where anyone will mourn your passing." Nothing whatsoever. "Timeliness" in death should not in any way, shape, or form be connected with how much people will mourn you or whether you are living "too long" for anyone to mourn you. Lives that go on beyond the time when people are mourned, on to a time when they are lonely and lack "affection relations with their kind" are emphatically not futile. We should never, never, never say that they are.

It's quite simple, really. Scruton is not a Christian. Scruton's vision of timely death is not a Christian vision. It might be rightly said to be a Stoic vision. When he thinks of love, he doesn't think of I Corinthians 13, which Wesley Smith uses so eloquently. Scruton thinks in terms of not being a bother to people, not being a burden, being strong, leaving while people still mourn you, and the like. He thinks of love as something you get if you don't outlive it. The Christian says that you don't have to be lovely to be loved, you don't have to be a "companion to be enjoyed" to be loved, that none of us deserves love, and that we are all called upon to love. And that the lives of the lonely and the unloved are anything but futile.

"Being able to turn phrases well won't get him far when he meets God"

You don't think so? (insert large snort of derision here)

I am a bit surprised about this Scruton discussion - I seem to have missed something somewhere. Are you talking about something Scruton said in the linked article or another post here? In any case, Lydia, if you are right in your interpretation of Scruton, that would make sense and it's a good illustration of how people like him who "get" almost everything except God - they end up in the same place as the frank atheist.

Kamilla

"The living dead" and "living death" are fairly common figures of speech. I wouldn't overanalyze them.

That's pretty funny. He's a philosopher and a professional writer. It's his job to choose his words carefully. I think he has.

"That's pretty funny. He's a philosopher and a professional writer. It's his job to choose his words carefully. I think he has."

He's also a fiction writer and a literary and aesthetics scholar. The book that Lydia excerpted from is not a treatise of analytical philosophy. Do you want to start taking Russell Kirk, Marion Montgomery, Roger Kimball, and other "men of letters" to task for not being analytical or exacting enough? Good luck with that.

"It's quite simple, really. Scruton is not a Christian. Scruton's vision of timely death is not a Christian vision. It might be rightly said to be a Stoic vision."

I can make no claims about his personal faith one way or the other. His views on these things may in fact be less than Christian. However -- he is definitely onto something when he decries longevity for longevity's sake. Wendell Berry has made a similar point, albeit without Scruton's (possibly) sub-Christian implications. I will leave it at that.

Rob G, it's one thing to oppose (though not, I hasten to add, with the power of law or of deliberate rationing) people's seeking longevity for the sake of longevity. It is another to oppose longevity per se, or longevity cum loneliness, longevity "beyond the point where anyone will mourn you," in short, to oppose longevity based upon the way that others view and relate to or will probably view and relate to the long-lived person, the person's quality of life, whether the person has "affectionate relations," and the like. The former may be defensible and has a long literary tradition, though (especially in our present world) it always has to be watched that it doesn't become the latter. The latter is never right. Never. That the latter is what Scruton is getting at is amply clear from nearly every word of the quotations I have given. As I say, I consider them wholly inappropriate, and if you said those same things, I would say the same.

Kamilla, the discussion of Scruton is of the quotations I give in the latter part of the main post, which are taken from a chapter called "Dying Quietly" (!) in a book, which I link from Google books. His proposal, which I summarize above, is discussed in the chapter, surrounded by much verbiage. As I say, the UK has now adopted that proposal.

Ah, I see the link now. Sorry I missed it earlier - I thought that was all Amis.

Rob, I think Scruton has been quite open about the fact that he isn't a Christian.

Kamilla

"Rob, I think Scruton has been quite open about the fact that he isn't a Christian."

Kamilla, this was true up until a few years ago, but in his recent memoir "Gentle Regrets," (2006) he describes his recent move back towards the Christianity of his childhood.

Lydia, I went back and reread the pertinent chapter in Scruton's book, which I own, and I must say that pulling the quotes out of the context of the entire chapter puts them in a decidedly more negative light than they appear in context. Scruton, in fact, discusses some of the very concerns you raise. In any case, to state that he's saying the same thing as Amis is, except in "somewhat more genteel terms" is not borne out by a reading of the entire chapter.

I was very careful about that, Rob G. I said that his solution is different from Amis's. I said that in the main post, and I have repeated it a couple of times in the thread.

That's not the point. The point is that both communicate the same notion that the elderly become a trouble and a nuisance by a) living too long and b) being unable to be "companions to be enjoyed" (e.g., demented).

Nor do I think the quotations are pulled out of context. They are very clear. Do you _agree_ with Scruton's _explicit_ statement that we should recognize the "futility" of living beyond the point that anyone will mourn us? I mean, it doesn't get much clearer than that.

And I must say that the "out of context" thing is what people say when their words condemn them absolutely clearly, out of their own mouths, and they don't like having this pointed out.

In any event, anyone is free to do what you have done and draw his own conclusion. That's why I linked the chapter.

Again, if you would say the things Scruton says, if you endorse his chapter--yes, context and all--then you are wrong. Badly, seriously, dangerously wrong. And by the way, part of that "context" that I didn't include was his specific proposal for refusing to prosecute those who assist in suicide and his nostalgia for the (I suspect, fictional) good old days when doctors deliberately left their patients lethal doses of morphine by the bedside and it was "none of the law's business"!

You may therefore regard my focusing on those quotations as _charitable_ to Scruton because of my not wanting to distract from the problem with his general _attitude_ to the elderly by a focus on his specific proposal. I notice, for example, that you have rejected his specific proposal but seem unwilling to condemn his general attitude.

I consider this problematic.

The point is that both communicate the same notion that the elderly become a trouble and a nuisance by a) living too long and b) being unable to be "companions to be enjoyed" (e.g., demented).

Exactly. I have enjoyed Scruton's books (including Gentle Regrets) but I have to say on this matter he does deserve criticism. A little too much cavalier Anglo Saxon 'thaes ofereode; thisses swa maeg" if you ask me....

Scruton, you dimwitted girl, not Dalrymple!

Rob, I said it myself so you wouldn't have to. Thanks for the correction.

Kamilla

Thanks, John,

I think there is a tendency to try to make conservative icons come out perfect. This is especially strong when the person in question is or might be converting to Christianity.

When Elizabeth Fox-Genovese was not a Christian, she published explicitly pro-choice views on abortion. In fact, her book _Feminism is Not the Story of My Life_, published shortly before her conversion, contains these same views. I suppose they would be called "moderately pro-choice"--abortion should be legal in the first trimester but prohibiting it becomes more defensible as the child develops. That sort of thing. Standard stuff. _First Things_ published a review of the book, by my recollection, right as she was being received into the Catholic Church. It was a new book; they were reviewing it. They were a flagship pro-life publication. The review did not mention the pro-choice views in the book. Didn't even mention them. Presumably the idea was that we shouldn't rock the boat, as we should assume she was changing all of that, etc.

I think this is incorrect. If a person does change his views, he should be encouraged _explicitly_ to renounce what he published earlier that was gravely wrong. Everyone will understand his doing so if the former views were pre-conversion. But the idea that gravely wrong views should be allowed just quietly to morph into _presumptively_ correct views while in the meanwhile all the rest of us just refuse to mention or reinterpret the gravely wrong views is just misguided.

"I think there is a tendency to try to make conservative icons come out perfect."

There is also a tendency to run conservative purity tests: "Hmmm...this guy may not really be one of us. Better keep an eye on him"

My great grandmother lived well into her 90's, addled by dementia for about the last 15 years of it. She never was hooked up to tubes or any other technology. Modern medicine probably aided her longevity to some degree short of extraordinary means. But longevity was really just a 'gift' of her constitution. It's not easy to love someone whose every move has to be monitored, whose every action causes some sort of trouble for someone else. I wonder what we should have done. Abandon her? What should the doctors have done? Not treat her? That's just another way of killing someone. I think she's the kind Scruton was talking about, not just the bed, machine and tube-ridden kind. Every now and then she'd have a lucid moment, and then the smile came back and we could see she was glad to have a familiar face around. In her last days, there were no lucid moments. Maybe a lethal injection after a whispered exchange with the doctor would have been appropriate.

Rob G, you still haven't told me whether you think it's true that we should recognize the "futility of living beyond the point where anyone will mourn our passing." If you cannot see that this is making the value of the person's life dependent on the attitudes and feelings of those around him, then I'm sorry, but you just can't read.

The value of Bill Luse's grandmother's life didn't lie in the fact that other people chose to love and care for her rather than resenting her for continuing to live. Rather, they made that choice because they recognized that her life had intrinsic value.

Scruton's entire discussion is a piece of blaming the victim. He sees a potential problem: People who are old, lonely, not "enjoyed," holding assets that younger people want, not loved. And he sees this as a problem of the old people, not a problem of the young people. Instead of seeing this as a problem with those who do not love, who crassly think about death in terms of inheritance, who abandon, etc., he sees this as a problem of people's living too long. And he sees the solution as exactly what the chapter is called--"Dying Quietly." His solution is sooner death, so that people won't live beyond the point where they are mourned, so that love will be restored, because love is being harmed by longevity.

This is not some weird interpretation born of a desire to enact a purity test. This is what Scruton _says_. This is what his discussion is _about_. And this is really, really wrong. It's just that he has this "wonderful, deep conservative thinker and writer" halo about him, and he sounds so well-intentioned and concerned, and he writes pretty well, and he surrounds this with a lot of profound-sounding talk about the value of life and the "philosophical view of death," and his solution (a combination of denial of some degree of medical intervention, which he does not clearly define but implies is extraordinary, including medicine, and suicide) sounds less vicious than do some other people (like Amis), and so I'm said to be uncharitable for reading *what he actually says* and criticizing it.

Maybe a lethal injection after a whispered exchange with the doctor would have been appropriate.

Only in a universe where God does not exist!

What, pray-tell is the difference in mental cogitation between your great grandmother and someone who is delusional, but young? Ought we to kill them both?

Amis is correct: there will be an age war in the near future, given how much the concept of love has been perverted and that perversion taught among the young and old generations. Only if a proper sense of love is restored can this be avoided. Remember St. Paul's prophecy (not exactly meant for this case, but applicable, still): "A time will come when those who kill you will think that they are doing God's will."

I, first of all, love the soul of a person and as long as that soul is on earth, it is something that I am responsible for, either directly or indirectly. When a person becomes incapacitated, love, true love, seeks to intensify, to restore the connection of souls, by whatever means. The most effective means is prayer and sacrifice. If people would spend less time plotting to off their aging relatives and spend more time fasting and praying for them, a revolution in care for the elderly would occur. We live in an age, however, where spending five minutes with a demented relative is seen as a cause for canonization. "No greater love hath a man then that he lay down his life for his friend." How far we are from that kind of love.

Amis does not understand love, so, naturally, he doesn't understand why loving the demented is a good thing for both parties. He seems to think that when the mond can no longer function, the spirit cannot grow or even soar.

One of the most intense spiritual powerhouses I ever knew was an old lady suffering from demntia in a nursing home. You could almost see her soul radiating spiritual light as you entered the room. I would not deny the world one minute of her presence until God calls her home. An army of dememted people, who have lived a Christian life, can, nevertheless, convert the world. The problem is that many older people in this age, have not lived a Christian life and their soul does not pray on after their mind goes. Their soul lives in a dark dungeon of torment and unrepented sin. These elderly are to be pitied and their number may be increasing, given the trends in modern societies.

The time to help the elderly is when they are young. Hasn't Amis figured this out? Once the soul has good habits, the mind may quietly go where it will. I am reminded of a statement that the compser Charles Ives once made: "My God, what does sound have to do with music?" One could almost say, "My God, what does the mind have to do with living?"

I pity Amis. So intelligent, but so unwise.

The Chicken

Lydia and Rob,

I've been thinking about one particular issue this morning and I hope you don't mind if I put in my 2c.

When we repent of our former rebellion, it sometimes takes a while to clear out all the cobwebs and really get our thinking straightened out. I know it took me some time to stop thinking and talking like a religious feminist in certain situations. I used to be rather proud of one particular thing I had done in aid of the religious feminist cause, even though I know it was in furtherance of heresy. But now I've finally come around to the view that I am *thankful* virtually no one knows of the pivotal role I played in that one particular project.

Now, if we're still wondering a few years down the road *when* he will repudiate some of his earlier language and realize he was still in the process of clearing out cobwebs, then I think we have a right to ask hard questions about the nature of conversion, etc.

Kamilla

What, pray-tell is the difference in mental cogitation between your great grandmother and someone who is delusional, but young? Ought we to kill them both?

Is this a serious question or a rhetorical one?

"If you cannot see that this is making the value of the person's life dependent on the attitudes and feelings of those around him, then I'm sorry, but you just can't read."

And if you cannot see that there is a subjective aspect to life and its value which is dependent on giving and receiving love and affection, then neither can you.

I would never argue against the intrinsic value of any human life, and as I said above, more than once, if that is what RS is getting at I'd strongly disagree with him. I will repeat: my point of agreement with him is in the repudiation of the idea that mere longevity is a good thing, and that this idea is the default mode of much modern medical practice.

To state this criticism, however, is not necessarily to fall into a euthanasiac mentality. If RS does that, he is wrong. But the criticism itself is not.

By the way, both my mother and grandmother died due to complications related to early onset senile dementia caused by arteriosclerosis. Both were in their mid-70s. My gram's condition was in the end exacerbated by a virulent form of leukemia. Thus I've seen this type of thing twice, once as a child and once, in the past 10 years, as an adult. I have personal experience with it. Mr. Luse should be thankful for his grandmother's occasional lucid moments. Neither my grandmother nor my mother had any -- once they were "gone" they were gone.

Lydia,

There is an element of truth to the issue of outliving one's talents. It will only get worse as science extends the human life expectancy, but the public expects to be able to retire at the same age. I hear elderly coworkers griping all the time about how retirement ages are slowly pushed back every so often, never once giving thought to the fact that it is a form of solonic compromise to balance the needs of the elderly with the need to not burden younger citizens with a crushing tax burden.

Euthanasia is not the answer, but society is going to have to get tough with the elderly, possibly to the point of disenfranchising the elderly who rely on state benefits.

Is this a serious question or a rhetorical one?

It's rhetorical, Bill. MC is one of the good guys. MC, Bill is one of the good guys.

Rob G, is this your answer to my question about the "futility" (futility is a strong word, note, not "sadness") of outliving the time when others mourn you?

And if you cannot see that there is a subjective aspect to life and its value which is dependent on giving and receiving love and affection, then neither can you.

Is that a "yes"? You agree that we need to recognize "the futility of living beyond the point where anyone will mourn our passing." If so, that's not good.

Neither can I read? As in, reading Scruton? What do you mean by a "subjective aspect to life and its value"? No, I actually believe that part of a Christian view of the world is realizing that our subjective feelings about the value of life are sometimes _wrong_ and adjusting our valuations accordingly.

Kamilla, I often find that people don't do much repudiating nowadays. To take the other example I gave, I've looked and looked for a place where Elizabeth Fox-Genovese said, "I used to be pro-choice. I was even pro-choice in the book I published shortly before I converted. I was wrong. I no longer think abortion should be legal, even early in the child's development." I've found some negative things she said about abortion. *As far as I can tell* (and I want to say that I might have missed some things in my search) everyone just took that together with her Catholicism and assumed that she had changed her mind about her earlier position. Now, that might be true. But I'm rather a fan of making clear statements on those sorts of things, especially when they were published, yea, even published in _books_, not just some comment made in passing on the Internet. After all, when one publishes a book, one polishes it, one reads proof pages, there's a certain definiteness about the whole process. I think when something is out there like that, unequivocal, and it's on a grave matter, and you change your mind to the point of doing a 180 on the issue, you should say just that: "I've done a 180 on this issue. I was wrong."

It seems to be considered crass to ask that or look for it anymore. But I don't think it's crass.

Mike T, I really question to what extent "science" is extending the lives of the elderly in many cases. I know it's a common phrase, but I think it's a phrase we need to rethink. I know some elderly people with things like pacemakers and such and heart medications. I guess you could say science has extended their lives, though that doesn't mean I consider it inappropriate. But people on pacemakers are hardly the hale and hearty elderly you have in mind who might as well still be working and are bored in retirement! If someone is that healthy, it seems to me a little odd to talk about "science" as extending his life. Sounds like he's just healthy. Maybe because he has taken good care of himself, has not had a body-harming job, doesn't smoke, and what-have-you. I think it's just too sweeping of a generalization to say that someone lives to be old because "science" extended his life. You have to look at the individual case.

I hold no brief for Social Security. I think it's a Ponzi scheme, and I bitterly blame FDR for sticking us with it forever. I think the people bilked by the scheme are those whose money is taken, as in a Ponzi scheme. But just as you wouldn't talk about "getting tough" on the people who lost their money in a Ponzi scheme, so I wouldn't talk about "getting tough on the elderly." I think that has an unpleasantly Big Brotherish sound, as if the elderly are whiny kids, and the government is Mom who has to discipline them. Social Security should be wound down, phased out. That will never happen, and one day, I'm afraid, the pyramid will collapse and people will be left in destitution, victims of a decades-long scam. I pity them. I'm being bilked the same way right now in my husband's checks. I wouldn't talk about "getting tough with them."

I do favor not retiring until you have to for health reasons. I think more and more people favor that as well. We should also disentangle age per se and health care, one consequence of which is that once you are over a certain age you are subject to the benefits limitations of Medicare *even if you have better insurance than Medicare*, which is hardly doing you any favors!

So, in one sense and on some practical things, I'm with you, but not in the terms in which you cast the issue, and probably not for the same reasons.

Lydia,

You're probably right - perhaps it is only no-names like me who bother to repudiate their past heresy, sin and rebellion.

Kamilla

Lydia,

If someone would die without a pacemaker, then "science extended their life." My wife would be dead without anti-histamines. I mean that quite literally--if she were born in the 19th century her allergies would have killed her by the age of 20 because they can be that severe. There is a causal link between scientific advancement in this area and her ability to suppress a genetic weakness that would have surely killed her otherwise. It is also reasonable to say that anyone who has had a potentially fatal condition cured by a doctor has likely had their life at least functionally "extended through science."

My point about getting tough with the elderly is that so many of them don't want to keep working, and I've met a number of them who draw at least 2 pensions. **2 pensions**. My grandmother knows a widow who nearly makes a 6 figure income because of her deceased husband's military pension, Maryland state pension and social security. Why should 2 governments pay a pension to the same person? If someone wants to argue "that's the terms of employment" well la tee bloody da, then I guess we can pay migrant workers $0.50/hour because that's the terms of the employment" there too.

A lot of my disgust with the state of things with the elderly is, perhaps, simply generational. I'm 26 and we're hoping to start a family soon. I'll be blunt and state that we both feel that a dual income household is substantially inferior to a single income traditional one with respect to raising kids. Expenses are rising, the elderly demand more and more and that is pitting our ability to have a family on our terms against the "needs" of the elderly. On top of that, some of the best, most affordable housing we found was "active adult," which is one of the few legal forms of ageism. It's legal to keep us out of an affordable community, but it's illegal for employers to fire elderly workers whose health care costs too much. It's an interesting blend of the cultures of life and death; we focus on the elderly and older adults to the point where we make it harder for people to have traditional families.

If someone wants to argue "that's the terms of employment" well la tee bloody da, then I guess we can pay migrant workers $0.50/hour because that's the terms of the employment" there too.


And I thought you were a libertarian. :-) I mean, why don't you say both of those?

On top of that, some of the best, most affordable housing we found was "active adult," which is one of the few legal forms of ageism. It's legal to keep us out of an affordable community, but it's illegal for employers to fire elderly workers whose health care costs too much. It's an interesting blend of the cultures of life and death; we focus on the elderly and older adults to the point where we make it harder for people to have traditional families.

What's this "active adult" thing? That you can't have children in the apartment?

Truth: I think nearly all non-discrimination laws should be repealed. This would allow both of the things you are talking about. I don't know if you would consider that preferable.

It's an interesting blend of the cultures of life and death; we focus on the elderly and older adults to the point where we make it harder for people to have traditional families.

Actually, this phenomenon is a result of younger families in the past few decades being unwilling to have many children. It is a vicious cycle. In the past, the elderly lived for longer periods with their families, going to nursing homes only in rare circumstances. Nowadays, there are fewer young people and their relationship to their parents or grandparents is more tentative. Given this, the elderly are more on their own to take care of themselves, thus, the higher need for a focus on how to sustain them by intervention.

The solution is obvious: young people who plan to have many kids should be unusually favored by society (good luck with that, however) and those kids should be raised to take care of their parents, in true Biblical fashion.

I realize this is unlikely to happen in our hedonistic and self-fulfillment-based society, but it is the correct solution, in most cases. Respecting the wisdom of old people tends to stabilize societies. One of the reasons that our society is fragmenting is that, increasingly, it is being run by young people who are not really philosophically nor emotionally mature and have been trained from birth (even with support from psychologists) to think only of the present moment. Young MARRIED couples who have many children almost always have to take the long view of struggling for their children.

If couples, such as yourself, could have many children, the cycle of abandonment of older people to government intervention would gradually decline. It is going to be hard for enough young people to be willing do this and one should consider them martyrs for the next generation, since they will be denying themselves so much, especially since short-sighted society will not support them, but rather, actively discourage them. The larger Christian community has a responsibility to support them, both emotionally and, if needs be, financially, while they go about the task of re-populating the country with people who appreciate older people. In that way, all segments of society will, in time, be supported and government and forced medical intervention disappear, for the most part.

The Chicken

I think there is a lot of unhealthy resentment floating around against both children and the elderly.

Just this past weekend I was asked to sign a petition to deny a special use permit to some people running a small in-home daycare in my neighborhood. I don't know the people, and there was no allegation that they are not good people or won't do a good job. They already have a permit for a daycare of up to six children and wanted to move it up to being allowed to care for up to twelve children in their home.

I was most unpleasantly struck by one of the reasons given for signing the petition: There are neighbors to these people who work the night shift and sleep during the day. They have trouble sleeping because of the sound of the children playing ("screaming" was the word used) in the yard of the house.

That one really got my dander up. If I'd been open to signing the petition before (and I really didn't see any reason to do so), that would have shut down any sympathy I had. So our neighborhood now is _supposed_ to be like a graveyard, with no sound of children playing, so people who work the graveyard shift can sleep during the day! That we have moved from the more or less accidental fact of "no sound of children playing" to people's demanding that as a _right_ seems to me rather creepy.

But I don't think the solution is somehow to be "tough" on the elderly. It's to teach the elderly and the young love for one another. Not that I, any more than MC, see this as happening any time soon.

Mr. Luse should be thankful for his grandmother's occasional lucid moments.

Did I give reason to think that I wasn't? Thanks for the instruction.

Neither my grandmother nor my mother had any -- once they were "gone" they were gone.

No they weren't.

Me: 'Neither my grandmother nor my mother had any -- once they were "gone" they were gone.'

Luse: 'No they weren't.'

Yes, I'm afraid they were, and after all, I was there. There were no lucid moments. Note that I'm not saying that they still weren't my mother and grandmother, objectively speaking -- I know that's not the case. Yet in a certain sense, we lost them long before they died. To state otherwise would not be honest.

So why bring this up, Rob G? Why does it matter? What's the point? Is the point that it would have been better if your grandmother and mother had had some sort of previous treatment rationed so that they would have died before becoming so demented? Is the point to defend Scruton's position that it's a bad thing for people to live until they are "no longer companions to be enjoyed"? Is the point that no one, or almost no one, would live to become demented if extraordinary medical measures were not undertaken? (That is completely false, but since you have referred both to dementia and to extraordinary medical measures, I wonder if you believe it.) Or does medical care become extraordinary _by definition_ if it enables people to live beyond the point where they are "no longer companions to be enjoyed"?

Here's the thing: Scruton brings up certain things--loneliness, not being companions to be enjoyed, other people's wanting to inherit--and presents _death_ as a solution to these "problems." You, well, you say you don't believe it's necessary to have a "euthanasia mindset" to say the things he says. So why are you bringing up what you are bringing up? Is death the solution to dementia as well? Would your mother and grandmother have been better off dead? Do you wish something had gone differently earlier so they would have died before that point?

I realize these are painful questions. But you are the one who brought the autobiographical element in, even to the point of pressing on the importance (for what, you do not say) of your mother's and grandmother's lack of lucid moments.

Me: 'Neither my grandmother nor my mother had any -- once they were "gone" they were gone.'

Luse: 'No they weren't.'

Yes, I'm afraid they were, and after all, I was there. There were no lucid moments. Note that I'm not saying that they still weren't my mother and grandmother, objectively speaking -- I know that's not the case. Yet in a certain sense, we lost them long before they died. To state otherwise would not be honest.

Honest about what? Let me repeat, until their soul leaves their body at death, as William Luse points out, they are NOT gone. They are not lost. This materialistic view about what constitutes a man is at the heart of the arguments for euthanasia. That the demented may be no longer able to respond in any meaningful sense to people by the world's definition means nothing, since it was not the world, in fact, which gave them their personhood to begin with and they, therefore, do not have the right to define when and under what circumstances it will end.

An ancephalic child will never have any lucid moments and yet, when they die, they are given the right to a Christian burial, not simply dumped in a dirt grave as one might do with an animal. It is a cross, to be sure, to have a family member who is demented and one must, in a sense, count their time on earth in a moral sense to be over (since they can no longer, properly speaking, sin due to lack of knowledge of what they are doing), but as long as their soul is still united to their body, they are still part of the Church Militant. What soldier, when he sees an incapacitated buddy, doesn't pick up the slack to get him home? In cases where there is a demented relative, God is not asking the demented person a question, he is asking the care-giver a question: do you love this person enough to care for them for the rest of their life, regardless of the inconvenience to you? The demented person is a living question of love. Christ was pierced with a sword so that the thoughts of many might be revealed. The demented person is Christ pierced with a sword among us. How we treat them reveals the thought of so many in the modern world.

My statement is simple: you really haven't lost them because they really haven't lost you. When the demented are abandoned, then they are truly lost, at least to the men of this world. That they can never truly be lost to God (whose representative to them you are) is something that should be pondered with fear. "Whatsoever you did to the least of my brethren, you did to me." That should be the guiding principle upon which all interactions with the elderly demented should be based. In the Old Testament, it is explicitly stated that even if one's father should lose his mind, one should not grieve him. I ask you, how is it possible to grieve someone who has lost his mind? Apparently, Scripture knows something about human relationships that we have, for the most part, completely ignored, today. Lucidity is not the defining point of humanity for God. It should not be for us, either.

I once knew a woman with Alzheimer"s Disease. I knew her for one brief lucid moment and the rest of my interactions with her were when she was out of it and yet, I would not trade those moments because somehow, in a way known only to God, we shared a bit of love, even though only one of the parties knew it. Modern societies have been so diluted in their understanding of love...more than the mistreatment of the elderly, this is the telling point and the judgment against any so-called wisdom I see in the "modern" treatment of the helpless.

The Chicken

Sorry, but I'm getting tired here. I've attempted to explain what I mean several times above, and apparently am not making myself clear enough. But I have neither the time nor the inclination to continue.

I'll close by stating that while I disagree with RS's prescription for the problem he identifies, he does in fact identify a real problem. As one who's experienced in his own life the things that he discusses, I cannot so quickly dismiss that discussion of them. Euthanasiac thinking and assisted suicide are not the answers to the problem, but that does not negate the fact that there is a problem. It does no good to downplay it by implying that the results of modern medicine/technology vis a vis longevity are all sweetness and light. To do so is to fall into the error of progressivism.

I never said anything about sweetness and light. Except in the ultimate sense in which such concepts are anything but trivial. I strongly endorse MC's comment above. A question and a cross are not sweetness and light. Neither are they a matter of "futility." Not by a long shot.

Rob G,
I'm sorry about the predicament you experienced with your mother and grandmother. One possible course that would have been better for everyone involved is a living will, but you'll never hear Lydia suggest it.

A living will saying what, Step2? Your implication here is that there was definitely something that could ethically have been _refused_ to the mother and/or grandmother, which refusal would have spared RobG and his family the cross of living with a demented loved one, and which refusal the mother or grandmother could have codified in a living will while still mentally competent. You assume this on the basis of radically insufficient evidence. Here is the sum total of RobG's statement about their medical condition leading up to the dementia:

both my mother and grandmother died due to complications related to early onset senile dementia caused by arteriosclerosis. Both were in their mid-70s. My gram's condition was in the end exacerbated by a virulent form of leukemia.

There is _nothing_ there that indicates that if only they'd had a living will, something could have been refused that would have avoided the pain he describes. I know that you, Step2, believe that food and water by tube are extraordinary means. But many people with dementia eat and drink by mouth for years and years. In any event, RobG has said explicitly that he is not in favor of withholding ordinary care, and it's not clear that he and you would define ordinary and extraordinary care in the same way.

As the saying goes, Step2, there you go again. Part of what I'm fighting in this whole post is the misguided and highly dangerous assumption that if someone lives to the point of giving relatives pain in these ways, this *must be* because some medical care was "too much," was an "overvaulting of science," and that the whole thing could have been avoided by an acceptance of "natural death." Whether this is true in some case or other, it is certainly not true _in general_. And the assumption, such as you make, that it is true in cases like this is a bad, bad assumption. People then look at someone living--perhaps sitting up, eating and drinking, not hooked up to machines, nothing--with dementia and think that somehow, somewhere, they got "too much" medical care, or they wouldn't be here being a burden on everyone else. Moreover, people think that writing a living will themselves is the solution to their not having to be cared for later on with dementia. Baloney.

Lydia,

What's this "active adult" thing? That you can't have children in the apartment?

Not only that, but you can't even own the property unless you're over 55.

Truth: I think nearly all non-discrimination laws should be repealed. This would allow both of the things you are talking about. I don't know if you would consider that preferable.

I would be happy to have them repealed, but since that is not a political possibility, I want to see those who have "escaped them" firmly ensnared by the state. The only way to escape this left wing mess is to spread around the misery as much possible. God knows women would have burned down the family courts long ago if the system were truly gender-neutral in how it metes out punishment ;)

The Masked Chicken,

Actually, this phenomenon is a result of younger families in the past few decades being unwilling to have many children. It is a vicious cycle. In the past, the elderly lived for longer periods with their families, going to nursing homes only in rare circumstances. Nowadays, there are fewer young people and their relationship to their parents or grandparents is more tentative. Given this, the elderly are more on their own to take care of themselves, thus, the higher need for a focus on how to sustain them by intervention.

It is the result of that, abortion and the increasing costs of marriage and having children. Many of the people who will soon be "elderly" are the very boomers who kicked off this vicious cycle. One of the things which makes me less sympathetic to the elderly is that they've had an entire lifetime to pay their way. Divorce has likely devastated a lot of that, but again, that goes back to personal and generational responsibility.

As I see it, my generation's paychecks are being eyed by older Americans much like a pack of wolves eyes a flock of sheep. Why should my paycheck and savings be strip-mined by taxation to fund every little health care expense and pension for the elderly masses who, again, have had an entire lifetime to pay their way. Unfortunately, there is no way to separate out those who were poor their entire lives or who were victims of unusual injustice that left them destitute in old age from those whose financial problems in old age are the cumulative result of bad choices. That's one of the things that angers me the most about this.

There is _nothing_ there that indicates that if only they'd had a living will, something could have been refused that would have avoided the pain he describes.

I don't know if there would have been a refused medical procedure or not, that is why it is up to the prospective patient to make those hard choices, so it doesn't fall upon relatives to do it for them. If they had made a living will that described exactly the treatment they were given, that alone is a comfort, to know with certainty what they wanted done.

As I see it, my generation's paychecks are being eyed by older Americans much like a pack of wolves eyes a flock of sheep.

I think that's a fairly ridiculous way of looking at it, Mike T. You know as well as I do, as my allusion to a Ponzi scheme indicates, that these older Americans themselves had their paychecks plundered in their youth under the guise of making them save for their own retirement, under the lie of the Social Security trust fund (yeah, right). And in fact, what was happening was that the money was going back out as fast as it came in, or faster. It never was being saved. But although in fact, the money for their benefits now is coming from the paychecks of the young, one major reason they do not have more saved is because they had the money taken from them involuntarily supposedly "for their retirement" when they themselves were young. This is hardly a matter of bad choices. They had no choice, any more than you do. Adding to this are those wonderful little announcements one gets in the mail over the years from Uncle Sam telling you that you would get X amount per month if you retired and your heirs would get Y amount per month if you died, _based on_ the number of years you have been working under Social Security, thus deliberately reinforcing the impression that this is an entitlement from a system one has paid into rather than something one is getting "like wolves" from some younger workers.

Now, here's another thing: You talk about not wanting to pay for the medical care of the elderly. Well, first of all, if it were your own family, it would make perfect sense for you to pay for their medical care. Second, the elderly in our country are already de facto rationed to medical care as paid for by Medicare. This is true even if they have supposedly supplementary insurance. So it's not like if only they were wise and foresighted, they could "pay for their own" and get something better. To imply as much recks without the actual state of government takeover already (and this is even without Obamacare) for the elderly. That's the way it works: Government provides something, then it becomes impossible for people to get that outside of the government system. Then people start calling for rationing on the grounds that it's "not fair" that they should be "required to pay for" these other people's care. But the other people have been, in essence, forced into the system.

The whole idea of the elderly as wolves eyeing your paycheck is just silly. They're victims of the Social Security scam as much as you are, and a life on Medicare and Social Security alone ain't no bed of roses, believe me. Yes, it should be phased out. But let's not be ridiculous with our "wolves" metaphors.

Let me ask you, Mike T: If you have Social Security taxes taken from your paycheck for twenty-five years, and then you die, leaving a wife and children, do you think your wife is bound in duty and honor to refuse the Social Security benefits (spousal and per child while the children are minors) that the Social Security administration writes and tells her she is entitled to as a direct function of the number of years you had those taxes taken out? If she accepts them, is she a "wolf" eyeing the paychecks of other workers?

Why can't the able elderly give back to the young in the form of community service? The young could save lots of money if an elderly army decided to take care of their child care, shopping, teaching home school, etc. There are other ways the elderly can help the young than by dying (which doesn't really help the young, anyway).

The Chicken

MC: Your 10:21 post is compelling, such an excellent articulation of truth. I have one small quibble; you say that only one of you understood that exchange of love, but we have no idea what the unresponsive person knows. With a severely mentally handicapped grandchild, and with both my father-in-law (now dead) and my father (still living) enduring dementia, I am more and more convinced that there is a place of response and reaction in those who can't communicate lucidly with us, and that our love is key to giving them comfort and dignity and giving their last years/months/moments some greater ease. In fact, that concept makes the rest of what you say even more compelling to me. When asked if I will love, I don't answer yes just to please my Lord; I answer yes to be of an avenue of God's love to the one I choose to love. Anyway, I really, really appreciate what you said and will probably disperse it among friends and students as the need arises.

When MC is good, he's very good, Beth.

Step2, there has not been the slightest suggestion anywhere in this discussion of distress caused by not knowing what the patient wanted. RobG suggested no such thing. Nothing he said indicated that. For all you know to the contrary, there could have been living wills or clear oral instructions consciously followed in both cases. That is a red herring. The distress we have heard about here--very real distress which I am in no way downplaying--was that of seeing and caring for people one loved in a state of dementia. That your reaction to this is, "A living will might have helped with that" is telling and, frankly, sinister. It's that sort of reaction in that sort of conversational context that gives people who push living wills a bad name.

I've attempted to explain what I mean several times above, and apparently am not making myself clear enough.

Maybe it can't be made clear without sending us in Scruton's direction.

Euthanasiac thinking and assisted suicide are not the answers to the problem, but that does not negate the fact that there is a problem.

Taking care of certain kinds of people can be painfully difficult, but these people are not problems to be solved.

Step2 said that is why it is up to the prospective patient to make those hard choices, so it doesn't fall upon relatives to do it for them.

Well, if those choices are morally permissible, what's so hard about them? I wonder what he has in mind. Not to mention the difficulty of describing "exactly the treatment" they are to be given, since none of us know what conditions lie in wait for us on the road to dying. The only possible description would be general guidelines for either withholding futile treatment, or for murder.

Anyway, I really, really appreciate what you said and will probably disperse it among friends and students as the need arises.
.

Me say something useful? Ha. There is something deeper, here.

I think there is a problem with smoke and mirrors in this discussion. Smoke and mirrors both deflect light, but in different ways. Smoke scatter light away from the individual, while mirrors reflect light back onto the person. Both, paradoxically, may hide the truth or reveal it.

We keep saying that people who are demented have no quality of life and we use that smokey rationalization to scatter the light of truth away from our own actions. Isn't it, rather, the people who dismiss the demented who have no quality of life or rather, do not understand what that quality really is? They are like the soldiers standing in front of the Cross who thought that Christ was merely dying. There is no virtue in that kind of smokey silliness.

The demented person is like a mirror, who reflects their care-givers light back at them. If you want to find out your shortcomings very quickly, spend a day taking care of an elderly person. One thing is certain, if you can't stand the judgment of the demented, you will never be able to stand in front of God's judgment. Why, oh, why, is the Fourth Commandment missing from the list of necessary things taught in medical school?

Mirrors, if they be pure enough and the light sharp enough, can so reflect the light back on the sender that no light can be seen at all. There are so many people who care for loved ones with Alzheimer's Disease who live in loneliness and darkness, not realizing, all the while, that they are being flooded with light, a double portion, in fact, but that the light is so intense and so pure that all they see is darkness. Such people are living a relational Dark Night of the Soul, not realizing how much sinful baggage is being purged from them simply by trying to love the demented person. In time, many years, in fact, after their loved one is dead, the effects of that love will bear fruit in a type of peace that will allow them to see the true extent of the love that had been shared between them. That peace, however, is not for today. Today must be taken up with anguish. It is the night of the triple question. Today, for all todays of the Alzheimer care-giver, is the prelude to Good Friday, the night when Christ sweat the blood of his love.

If my comments earlier in the day had any value, they should have led those who read it to offer a prayer for all of the people they know who have been lost, for a time, to dementia and most especially for their families. It is the demented, after all, who are really speaking in those earlier comments. It is the debt I owe them. You think that I, a miserable sinner, could say anything of use? No, it was really their lives that spoke. This is what I mean: we think that demented people cannot communicate, but their lives do speak and their love does last. A woman I knew for a short period over twenty years ago, who, at the end, would never have understood a single word on these pages, has yet left a better memorial than I could ever write because I was allowed to show love to her and in the process, learned to love better.

That is why we should never give up on the demented. How I wish I lived what I write! I wish we had a confounding army of people who cared for the elderly - an army to puzzle the doctors who only know of their brand of quality of life and an army to make the angels smile.

The Chicken

P. S. I accidentally drank some caffeine tonight (something I haven't done in twenty years). I am sure it has made me write too much.

I think you should drink caffeine more often, MC!

We were unable to care for my father-in-law, and we were so blessed to watch his wife love him throughout those years. She was a lesson of love to us constantly. Thank God for those who simply love and act in that love.

That your reaction to this is, "A living will might have helped with that" is telling and, frankly, sinister.

It is not sinister to talk about giving a patient choice over their own care in the future. Maybe your doctor should just make all your medical decisions for you, since they "know" what you really want until it becomes unprofitable. Your preference that patients should not have any choice is based on an assumption that people will choose any and all measures to extend their life. That assumption is open to verification, but you don't want to accept the result.

I think you should drink caffeine more often, MC!

While I was trying to be a little glib in my comments about caffeine in my post, above, this is actually serious, for me. I have a cavernous angioma of the brainstem and caffeine, especially in the VitaminWater I drank which contains twice the amount of caffeine per volume of coffee in the form of the Guarana berry (I did not read the label carefully), decreases platelet aggregation (is a blood thinner) and can cause my angioma to bleed. Not good. For this reason, I also cannot take aspirin or any over-the-counter pain killers (all blood thinners), so I must suffer sinus migraines, etc., unmedicated. I only drank one bottle, so, hopefully it will clear my system quickly without any ill-effects. In any case, this is why I don't drink caffeine-containing beverages (plus, given my tendency to talk at the drop of a hat, run around like a, well, chicken, and lack of sleeping, they would be redundant, in any case). Chocolate is also off the menu, as it contains caffeine, as well. Enough of my medical issues (regarding these sorts of things, people often have the urge to pray for me, but I specifically ask that they don't, unless I ask.)

We thank you for watching this episode of Pity Me Theater. Please, be sure to buy our teeshirt. We now return you to our regularly scheduled blog.

The Chicken

Ah, I see. Well, see if you can find a safe stimulant that gives you the same brainwaves. :) (Seriously, I understand your predicament. A cavernous angioma is nothing to mess around with, and I wish you the best in dealing with it.)

Your preference that patients should not have any choice is based on an assumption that people will choose any and all measures to extend their life.

I can't speak for her and probably shouldn't try, but I think I know her well enough to say that that's not her opinion at all.

Lydia,

I think that's a fairly ridiculous way of looking at it, Mike T. You know as well as I do, as my allusion to a Ponzi scheme indicates, that these older Americans themselves had their paychecks plundered in their youth under the guise of making them save for their own retirement

While we agree that it is a Ponzi scheme, I am one step ahead of you in noticing that there is a concerted effort to keep it going by any means necessary. It's offensive to the average person to say that there is little difference between Social Security and Madoff's scheme, but imagine if Madoff's victims were allowed to recoup their costs by making him able to add more victims to his scam.

Just because they got screwed, why should we?

Let me ask you, Mike T: If you have Social Security taxes taken from your paycheck for twenty-five years, and then you die, leaving a wife and children, do you think your wife is bound in duty and honor to refuse the Social Security benefits (spousal and per child while the children are minors) that the Social Security administration writes and tells her she is entitled to as a direct function of the number of years you had those taxes taken out? If she accepts them, is she a "wolf" eyeing the paychecks of other workers?

In the case of my wife, yes, and she feels the same way. That's why we have life insurance through our employers. At the very least, if I die while she's young, she'll have our modest mortgage paid off in full.

In its current form, Social Security is a retirement ponzi scheme. It is workable as a welfare system, and if it were made into a welfare system by means testing, I would have no problem with it or its recipients (generally speaking). What disgusts me is that middle class workers qualify for it.

The Masked Chicken,

Why can't the able elderly give back to the young in the form of community service? The young could save lots of money if an elderly army decided to take care of their child care, shopping, teaching home school, etc. There are other ways the elderly can help the young than by dying (which doesn't really help the young, anyway).

Great idea, but you'll have them foaming at the mouth in rage if someone suggests even something as simple as making them do 5 hours a week of compulsory public service like working at a day care center without pay to help working class families that rely on dual incomes to pay for daycare.

Ironically, they won't bat an eye in most cases at drafting people of my generation into compulsory "national service." I've heard grumbles from elderly relatives and coworkers about "national service" for my generation, and whenever I quip about drafting them to even do stuff as simple as tutor poor kids in public schools, they get rather upset...

In the civil war, the confederate soldier often called it "the rich man's war, but the poor man's fight." That's what this is right here.

Step2, as Bill Luse points out, you don't really know what measures I think it ethical to refuse. The bent these days is all towards refusing *food and water*, or even a course of antibiotics for a simple infection, and what you usually hear me doing is speaking against that bent. Given that I often talk about ordinary vs. extraordinary care, you might infer that I _do_ believe there are things it is ethical to refuse.

However, my point then and now is that you, Step2, are changing the subject. We started with a commentator who told us about the sadness of a mother and grandmother who lived with and died of complications related to dementia, who told of that as if in some way it supported Scruton, who, in turn, tells us it's "futile" to live too long. You told the commentator that perhaps a living will would have been "better" for everyone involved, as though somehow the fact that his relatives lived long enough to live with dementia showed that there wasn't a living will. I have pointed out again and again the folly of such an assumption and the dangerousness of assuming that a person who has dementia must have received some care that, if he'd only thought ahead, he would (and perhaps should) have refused. There is, in fact, no reason to think this. I have pointed out again and again the physical fact that many people with dementia do not need anything remotely like medically extraordinary care. I have also pointed out that there was nothing in the commentator's comments to indicate that *not knowing what the relatives wanted* was the distress involved.

You ignore all of this and hare off after a discussion of my putative desire to see everyone on kidney dialysis or whatever you imagine I require.

You're ducking the fact that you made unjustified assumptions and implied--which is indeed sinister--that people should write living wills so that they will die before they get demented, which would be "better for everyone involved."

Not that I expect you to admit this.

Yet another story, today, about some people in a misdiagnosed vegetative state being able to communicate with people.

The Chicken

Lydia,
I will not admit to what you are saying I implied because it is patently false. I don't want people to die before they get dementia, I want them to tell their doctors and relatives beforehand what sort of treatment they want to receive after they have dementia. That should not even be controversial, much less sinister. I will admit to making a few assumptions which may be more or less justified, but they are based on a perception of his conflicted emotions, not on the assumption that he was unwilling to "carry his cross".
http://www.newyorker.com/arts/critics/atlarge/2010/02/01/100201crat_atlarge_orourke?currentPage=all

Unless you qualify it a good deal more, I will also dispute the blanket assumption that simple infections are responsive to simple treatment in those with compromised health. One of my best friends has a degenerative genetic condition, his most recent visit to the hospital began because of a simple infection that took two months to get rid of. Four more months of hospitalization were needed to deal with all of the other problems that arose, including temporary kidney failure, a three day coma, muscle loss to the point he is still in therapy to regain the ability to walk, and becoming addicted to pain medication. He has been clear all along that he does want extraordinary measures taken, so I am happy to support him in his efforts. I can also imagine someone who thinks the same outcome is not worth the treatment. I would support that decision as well. In short, these bright lines you want to draw between ordinary and extraordinary care are sometimes fuzzier than you think.

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