Talking Heads ~ A Duty to Die?

[ANNIE]

Talking Heads #9

"It occurred to me that nothing is more interesting than opinion when opinion is interesting..."
Herbert Bayard Swope, creator of the Op-Ed page.

A two week  forum for opinions on anything in print: magazines, newspaper articles, online: bring your ideas and let's discuss.

Our Ninth  Selection is: A Duty to Die

Is this what we've come to now?


Don't miss this very  provocative article titled  Higher Ed Can Lead to Lower  Values  in the  Columbus Dispatch on May 14, 2010,

http://www.dispatch.com/live/content/editorials/stories/2010/05/14/higher-ed-can-lead-to-lower-values.html

 and let's talk about some of these issues,  because there's a LOT here he covers, including escalating solutions for the elder generation, education, the virtues of poverty and a lot more!

Let's discuss!.

There are several things that can be eliminated after death.  One is the casket, the other is the chemicals they put in us (for display purposes).  We can also eliminate all unnatural things by being buried in a cemetery that only buries untreated bodies.  There are many things offered for natural burials, including wood caskets that will disintegrate in the ground, body pods for carrying the body to the cemetery, choices offered for burying ones body in the ocean where it will become part of a reef.  All kinds of different ways to offer one's body to science.
I have a poem somewhere about these choices and have placed a copy of it in with my living will saying that this is what I want done with my remains.

[kidsal]

My cousin has willed her body to U of Iowa Med School.  When she said they wouldn't pay to have the body sent to the college, we told her we would let her hitchhike by putting her in a box with one arm sticking out holding a sign pointing to Iowa City.

[mrssherlock]

Kidsal:  Thanks for the chuckle!

[Pat]

Kidsal -- even so transporting the body to Iowa City is cheaper than a casket or cremation.

But you have a good idea, I'll pass it on to my daughter.  She has suggested giving me a free ride to Iowa City in her horse trailer or the back of the pickup.

[Steph]

We opted for cremation. MDH is in my closet waiting for me to join him.. I know it is silly, but I do talk to his ashes.. Helps me cope on some days. Went with my older son and wife to Biloxi  for a few days gambling and getting away.. Had a wonderful time, but each time I return from being away, I cry because he is no longer there to tell of my adventure.. Life does get complicated.

[Pat]

Steph -- You're doing the right things.  Crying really helps.

[Steph]

I know I  have a Terry Prachett in my TBR pile.. I need funny... out loud laughing kind of book.. So will dig it out..

[Aliki]

I've been following this discussion off and on and the one thing I can't wrap my head around is the "importance" of the 70+ individual.

I'm no political economist but why isn't anyone speaking out in the NY Times or other paper about the blithe way society has about sending our young men and women out to war for many and any reasons, mostly $, land and power IMHO.

As I said before, I can't understand this subject although as I go a little further into my 70's I see the quality of my life dwindling.

Think I'll make up a list of people throughout the world who 'made a difference' living beyond the 'three score and ten' mark.

[Steph]

There have been and are many many people who after 70 have contributed to the world.. Some of my personal heroines did their best work after that age.. I am 72 and admit that in some ways I have slowed down, but I still mostly feel good, go to the gym, read.. walk and enjoy.. The accident has caused me to stop and think of my life, but I am valiantly trying to redo the way I have lived and forge on as a oner instead of a twoer.

[ginny]

I'd like to see a list of older achievers, to go along with our spectacular results by our own Latin students here in the April 2010 National Latin Exam.  4 perfect papers,  in 3 of our cases, they were in the top 500 out of 138,000 test takers, in one case in the top 700 our of 13, 800.

14 first places, 12 gold medals, 1 silver, 1 Magna, and all from people definitely not teenagers. An incredible feat I hope to hear more about the last of June at the national American Classical League conference at Wake Forest University where the National Latin Exam will present "Results and Revelations on the 2010 National Latin Exam." I'll have my pencil ready.

You can do good work, spectacular work and learn anything at any age!!

These statements from the article are attempting but I'm  not sure succeeding in making the point that affluence and education are the cause, perhaps the root of our caring less about the elderly.

I only began to hear that kind of talk decades later, from highly educated people in an affluent age, when even most families living below the official poverty level owned a car or truck and had air conditioning.

It is today, in an age when homes have flat-screen TVs and most families eat in restaurants regularly or have pizzas and other meals delivered to their homes, that the elites - rather than the masses - have begun talking about "a duty to die."

Back in the days of Aunt Nance Ann, nobody in our family had ever gone to college. Indeed, none had gone beyond elementary school. Apparently you need a lot of expensive education, sometimes including courses on ethics, before you can start talking about "a duty to die."

These efforts at changing values used to be called "values clarification," though the name has had to be changed repeatedly over the years, as more and more parents caught on to what was going on and objected. The values that supposedly needed "clarification" had been clear enough to last for generations, and nobody asked the schools and colleges for this "clarification."

  Does he succeed in convincing us? Is he right?  I'm certainly not a sociologist, but I would think there's nobody who knows the situation better than those who lived through it.

What DOES account for  Aunt Nances of the world no longer spending time with each family member, or have they  actually stopped doing that? I  know families where that's still done, don't you?

Could Medicare and her own preference to be self sufficient have anything to do with it? What about our mobile society? In the time he writes of, with no electricity or indoor plumbing, few  left home, (I may have to take that back, did you see American  Experience last night? It was about the Great Depression and the hoboes and young men riding the rails who had to leave homes which could not support them)...eye oening...but if they could most people stayed close to home. When did that change? Today's society is on the move, up to the job opportunity and out. I wonder how close our author lives to the place he was born.

How many of you live within 10 miles of where you were born?

Why would Aunt Nance be moving about at all? There's something wrong here with the reasoning and I'm having a problem making the connections between education, and caring for anybody. When he had to make choices between his child and his own success, it was a "Harvard educated" person who advised (who IS this he's talking to at Harvard? Does graduating from Harvard mean you have become God in all areas of life?  There are a lot of strange fallacies here in his reasoning, I think. I am not seeing the root of them however.

Pat, bless your heart I can't believe you kept that. I am sure I meant that IF you have a brain at the end, fill it up.  I'm beginning to wonder about myself. haahaa.

[Pat]

Pat, bless your heart I can't believe you kept that. I am sure I meant that IF you have a brain at the end, fill it up.   

Yes, I think that's the meaning I got from it.  If you stop learning, you're mind goes dead.

[Steph]

I must confess that rereading the article makes him every sillier with each reread. He is making incredible conclusions based on very little data.. Not clear thinker for sure.
My Dad only went to the 8th grade in formal school. But he discovered the ICS early in life and spent his whole life taking classes by mail. He loved learning for its own self. I would have love to have talked to him about this article. He felt very strongly about his parents inability to understand their childrens need to learn. When I was a little girl, since my Dad was the oldest in the family, all of my aunts and uncles at one time or another lived with us.. They moved on with jobs and families.
I have never lived 10 miles from where I was born since marriage.. I remember where I grew up with much love, but it is far away in Delaware. Sometimes I wish it was closer..But my sons live in Southwest Florida and I know I wont beable to go far from them..

[roshanarose]

Gosh!  What a wonderful response to such a controversial topic.  I am a Newbie and this is my first post.  I am Australian.

This topic reminded me of a difficult time in my life when I was an assistant nurse in a geriatric hospital.  The patients there ran the gamut from 60 to 90.  They were all "unwell" in some way or another.  What I remember most was one patient who had had both of her feet cut off due to heel bedsores and a deep hole at the base of her spine.  Her arms/elbows were literally wearing off.  Her pain must have been excruciating.  On one very rare occasion that she was not heavily drugged to combat the pain she whispered to me as I was changing her bed "Please kill me, dear".  However, many of the other ladies whose physical condition was not serious also wanted to die.  Our culture is probably to blame.  Solution:  I don't have one.  As for me - my daughter is under very clear instructions for when I want her to "pull the plug".

[Steph]

Having just gone through a pull the plug situation , it is not as easy as it should be in the US. Even with a living will and testimony from the family, when my husband was in the coma and getting sicker and sicker, I still had to write a statement and sign it in the hospital. That is so terribly hard for the survivor.. You agonize no matter what.. The worst single day of my life was November 20..

[maryz]

{{{{{{{Steph}}}}}}
I can't begin to imagine what you went through, Steph.  But, John and I have made ourselves very clear verbally and in our living wills as to our wishes. And can only hope "the system" will let that happen when the time comes.

[ANNIE]

I have a friend who grew up during the Great Depression and she spoke of her parents taking in relatives who had lost their jobs.
When I was a child in the '40's, my parents rented rooms to boarders who couldn't find a house to rent let alone buy.  My husband along with his mother and two siblings lived with his grandparents in Toledo, OH while his father, at a new job in Indianapolis, searched for a place to house his small family.  It took a year or longer to find something appropiate.   

[Steph]

My parents lived with her parents during WWII.. My Dad worked in the shipyard with my grandfather. He was 4-f.. due to losing sight in one eye.. I think that our generation has a lot of several generations in one house. My mil  had her Mother with her during most of her marriage. Not money,, just because..

[bellemere]

I have often read the syndicated columns of Dr. Sowell - I believe he has a Ph
D. like a lot of educated elite= and this one is right in line with his ultra conservative beliefs.  I also believe he is sincere, and not trying to rabble-rouse like the talk show hosts.  But his oppostition to the Health Care Reform Bill comes across as stornger than his convictin that educated elites are prescribing death as a corredrive for our Medicare problems! 
I read recently that there is a school of thought  on the epidemic of obesity: don't treat it.  Let them die from diabites, or heart disease , as soon as possible and save the " system" money. Same with the smokers.  They are actually doing us a favor.  How about that for a cynical take on health problems.
No one has a duty to  die, but a patient has the right to decline further treatment.  My neighbor did , with a recurrence of her cancer and spent her last months at home with hospice care.  But it was her decision.
I'm going to raise this question with my kids and hope they will give me an honest answer.
Who are the corporate sponsors for the talk show ranters?  I can always boycott them, just tell me who they are.

[Steph]

 I like the idea of boycotting the talk show ranters.. Must look into who sponsors them..

[ANNIE]

No problem boycotting talk shows as I just don't like them.  Even the news shows.  They are all rabble rousers and only interested in themselves and money.
My mom died in 1995 at age 83 and she had said many times in the previous months that she was ready to go.  Held my hand and uttered those words.  She had a long unusual life and was just ready to leave this planet for a better place which she strongly believed was truly waiting for her.

[bellemere]

Let me be clear about the obesity epidemic.  those in favor of aggressive action to stem it point out that obese people are so prone to serious illness, costing the health care system a lot of money.  Others say, "but they die much earlier, thus saving money for the system."  No one can put a number on this - yet.
I don't want to out-Rush Rush in exagerration.
What Sowell is saying , I think, is that the value of human life has always influenced our laws and social policies.  He believes that we got that way of thinking from religious beliefs, passed down from one generation to another.  But now, with the decline of traditional religion, perhaps the intrinsic value of human life no longer is part of our thinking. 
But secular humanists and even atheists also , in many cases, revere life as much as those grounded in God-centered beliefs.  Just as scientists believe that humans are  hard-wired for speech and communication, we are wired to value llife and its preservation. What do you think?
Does the belief in an afterlife , or loss of that belier , alter our thinking about the value of human life?
That story of the terribly ill old woman who longed to die really moved me.  I am sure many people express  that wish.  Should they be allowed to fulfill it?  With doctor assistance? Is that making "quality of life" the overriding value rather than life itself?

[winsummm]

duty to die? no but willingness is something else again. every morning my body treats me like an unwelcome visitor, literally hates me and I have to remember that with advanced aging this  just goes with the territory, the arthric old bones and spasemed  muscles which let up later in the day. but at the time I'd just as soon not be visiting.  

[bellemere]

What about young people who become serioulsy ill and need expensive care?
Surely nobody thinks they have a duty to die. Doesn't 'duty" mean the conscious sense of oblgation?  Or is duty imposed by someone else?

[Steph]

Interesting thought. Noone has a duty to die. I know my Mother had colon cancer, but at the end, she would whisper... let me go.. and we tried very hard to reassure her that we would..

[bellemere]

I think Thomas Sowell in his article was not saying that people have a duty to die; quite the contrary, he is saying that that is a notion that highly educated people propowe.  "Higher Ed leads to Lower Values" seems to omply that the more edcuated you are, the lower your moral values.  That is really generalizing.  Does he want people to stay ignorant and never question anything that they have been taught?  this seems to go along with a general distrust of intellectuals in government.  I remember how the Best and the Brightest brought u;s Viet Nam.  Bur I wonder if electing less educated peole to positions of responsibility would be a good solution. 

[bellemere]

Aliki, the New YOrk Times columnist Bob Herbert has indeed summed up the futility and tragedy of the Afghan war in an article today. 
The Courage to Leave.  .  I don't know how to forward an URL but I googled new York Times on line and got to read it there.

[Steph]

Why oh why does our nation think they should solve the worlds problems by interfering with foreign governments. We have been in way too many areas that all we did was mess up the place further. Our secret agents seem to unfailingly pick the wrong guy to back.. Maybve something wrong with our diplomatic corp and how they pick their help??

[Janet]

Those who have raised questions about the allocation of medical care and how it might affect the elderly (death panels?) might be interested in reading the following article that appeared in the prestigious medical journal, The Lancet. One of the authors, Dr. Ezekiel Emanuel, is a health care advisor to President Obama. I believe it was this article, and Dr. Emanuel's influence with the president, that gave rise to much of the concern that medical care under the national health care act could be denied a person based simply on age. Copied below is a summary of the article as presented on The Lancet website.


The full article is availabe for free (but you do need to register) at: http://www.thelancet.com/



"Principles for allocation of scarce medical interventions"

Govind Persad BS, Alan Wertheimer PhD, Ezekiel J Emanuel MD

The Lancet, Volume 373, Issue 9661, Pages 423 - 431, 31 January 2009

Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and disability-adjusted life-years. We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles.

[ANNIE]

Would Dr Emanuel be  related to Rob Emanuel by any chance??  Thank goodness my husband got his heart pump before we went to socialized medicine.  This sounds like Nazi Germany in WWII!

[Janet]

Would Dr Emanuel be  related to Rob Emanuel by any chance??

Yes, Rahm and Ezekiel are brothers.

Along this same line, the article by Thomas Sowell referred to the restriction of some medications and treatments for the elderly in Great Britain; a statement which some posters here seemed to question. We have just returned from two weeks in Scotland and England, where  we read the newspapers every day. Articles appeared frequently about this very subject, with specific cases noted where treatment is being denied based on one's age.

[Steph]

Like it or not.. there are certain medical things that are scarce and probably always will be.. I am 72 and I truly believe that if the choice was between me and a woman in her child bearing years with her life in front of her,, she should get the medical intervention,,not me..

[Janet]

Like it or not.. there are certain medical things that are scarce and probably always will be..

But why should this be acceptable? In all the debate surrounding the health care act, and in the act itself, I recall nothing about establishing a policy that would encourage the expansion of medical research and production of equipment or pharmaceuticals, medical degree programs, or that would provide incentives for the medical industry to meet the medical needs of all. Instead, there seems to be an obsessive fear that the large corporations and physicians might actually become wealthy in the process of doing business, so the government's response is to pile on taxes and burdensome regulations.

I am 72 and I truly believe that if the choice was between me and a woman in her child bearing years with her life in front of her,, she should get the medical intervention,,not me..

I believe Thomas Sowell's article speaks directly to this. Barack Obama is a well educated man. When asked by a senior citizen at one of the health care town halls about whether medical procedures could be denied because of age, his response was that perhaps the senior should take a pill and forget the surgery. I think we can presume that Dr. Emanuel and his colleagues who authored The Lancet article are highly educated people. In that article they propose a policy that would give medical preference to my twenty-two year old grandchild over your two year old grandchild; and the seventy-two, eighty-two or ninety-two does not even fit into the equation. In other words, "old people have a duty to die" -- and perhaps even a seriously ill child?

Why are these approaches acceptable? Why are the people of this nation -- which led the world for generations in industrial output, which put a man on the moon -- so willing to accept the proposition that medical resources are limited and "probably always will be"?

[Steph]

I guess it depends on the medical resource. I was actually thinkin of  replacement hearts, livers, etc. I know several people who have gotten new hearts and new lungs..Both of which are hard to get.. The people were in their late 60's and not in good health besides the problems. Seems unfair to me that they got the hearts and lungs instead of younger people who might live longer.
As far as medical resources of other types.. it all depends.. I have several doctor friends who would tell you that certain medical procedures are so hard to tolerate that most older people could not.. No idea how true that is..But I still stand by my feeling that I should not be first in line for certain types of procedures. Not all, mind you.. but some.

[Janet]

I have several doctor friends who would tell you that certain medical procedures are so hard to tolerate that most older people could not.. No idea how true that is..

I am sure that is true; but not performing a procedure because it would be detrimental to the health of the patient could apply at any age if the illness has sapped the body's ability to tolerate it. My point is that age alone should not be the determining factor.

But I still stand by my feeling that I should not be first in line for certain types of procedures. Not all, mind you.. but some.

And I respect your feeling; but that should be your decision, not the decision of the federal government. Again, my point is that that choice should not have to be made. It should not be an either or decision. If the powers that be were truly concerned about maximum health care for everyone, they would be looking at ways to expand medical research and development, manufacturing, education, bringing costs down. Instead, the focus is on cutting back, closing hospitals, denying coverage, limiting choices.

[bellemere]

It seems we agree that no one has a duty to die.  But the problem is that as a civilized society, we have a duty to use scarce resources wisely.  Their has to be a baisis for assigning resources like donated organs.  Until now, the basis has been money; sufficient insurance to cover the procedure. 
The parmaceutical industy seems to be less dedicated to research and development of life-saving drugs than "lifestyle" drugs like Viagra; meds for indigestion, meds for restless legs, etc.  Their plea is that only by marketing these drugs can they afford to do research on real cures.  But they don't seem to be coming up with much, do they?  the profit lies in developing meds for "lifetime" illnesses that are never cured, just treated.  My particular gripe is the space program.  I cannot stand it that I had to lose my dearest friend to ALS and we are going to put a man on Mars.  The war, too, is consuming so much in resources that are needed.  Janet is right in saying that the answer lies in developing more and better health care for everyone. But we will always be faced with allocation decisions, it seems, and must work it out based on our best knowledge and ethical concerns.
I am terrible on noting citations of articles, but I do remember one about a 92 year old, terminally ill patient being subjected to an incredible number of "tests
 and "procedures, including, so Help me, a Pap smear. 
My nurse daughter calls this game, "Pass the patient, please"

[Steph]

I agree on the patient at 92.. My mother in law lived until 98 and had severe dementia. Still the last months of life, we fended off doctors who wanted to implant a feeding tube,, do cataract surgery,,etc etc.. including as I remember a Pap smear and a mammo.. Hospice was a big help for us..

[pedln]

This is a long article, and I have not read it all, but it is so fitting for this discussion.  A man in the beginning stages of dementia needed hernia surgery.  The surgeon refused to do it unless the patient received a pacemaker.  The patient’s primary care physician, who had known him for years, was not consulted.

What Broke My Father’s Heart

Now I would look at him and think of Anton Chekhov, who died of tuberculosis in 1904. “Whenever there is someone in a family who has long been ill, and hopelessly ill,” he wrote, “there come painful moments when all timidly, secretly, at the bottom of their hearts long for his death.” A century later, my mother and I had come to long for the machine in my father’s chest to fail.

[Octavia]

I'm just getting back online, my computer had a nervous breakdown.
I don't have time now to read all the posts, but I have a couple of comments. Sometime ago, here in Australia, a surgeon spoke on TV about the amount of elderly people with little hope of a recovery, filling Intensive Care beds for extended periods. He said pressures on our Health system meant that we should be considering whether our health dollars could be better used saving young people with many years left.

My youngest is turning 30 at the end of the year, and I would give up my right to an Intensive Care place in a heartbeat if he needed it. There is so much he hasn't experienced yet.

Steph, you're a bit tough on us Baby Boomers . There are probably more of us on SeniorLearn than you realise. We're not all the same.

[Steph]

Dont honestly mean to be tough on anyone.. My two sons fit the age grouping for baby boomers at the far end.. being born in 61 and 64.. However many of the groupings do not apply to them..

[Eloise]

I am shocked by idea that we have “A Duty to Die”. But without it being a duty then, while we have the capacity to decide how much medical life prolonging we want in the end, we should make our wishes clear to our loved ones about how our death should happen.

Children often don’t want to “pull the plug” because they love their parents, but it seems that the responsibility becomes theirs when life doesn’t want to quite and elderly parents can’t decide for themselves. 

My mother, always the wise one, decided to just stop eating. At 95 she was almost blind, was deaf,  had Alzheimer’s, was bed ridden, but she had no other illness, she just wanted to die and we all agreed that she deserved that her 5 children who were all present, let her go. We held her hand and sang a song she loved, she sighed and stopped breathing.

That’s what I want too but in the meantime I do everything I can to stay healthy naturally and I need help from the medical profession when it’s necessary to make life tolerable.

To prolong the life with years of pain and misery just for the benefit of the medical and pharmaceutical “industry” is elder abuse IMO. 

By the way I love our public health care system in Canada, I wouldn't be alive if it weren't for that.