The Way We Die Now

Our sense of common decency − of kindness − has become sclerosed.

In novels, death is portrayed as the logical, inevitable conclusion to the life that has led up to it. Of course, life (and death) just isn’t like that. There is no core personality; it alters over time and within time. This explains why the cowardly sometimes die well and the brave sometimes die badly. Those who are most attached to their own personalities find it hardest to die.

Being a burden is the antithesis of contemporary atomization and aggressive individualism. We should want to be a burden to those who love us, and they should want to bear that burden.

It therefore follows that had man never sinned he never would have died [my italics].
In our own post-Christian society, we have come to believe in a similar doctrine. But the sins are not those I learned about in my catechism as a child; the sins that cause death are not old-fashioned ones, such as avarice, sloth, gluttony, anger, lust and so on, but newer ones, such as smoking (now also an official Catholic sin), low fibre intake, lack of regular exercise, failure to take advantage of preventive measures against ill-health and ‘internalizing’ anger. Healthiness has become the new godliness.

The American philosopher and physician Leon R. Kass predicts a future of ‘protracted youthfulness, hedonism, and sexual licence’.

Our problem with death is that, compared to our ancestors, we live so long. We know, in theory, that we must die, but we have banished death from our thoughts.

A 2003 study from Johns Hopkins University examined doctors’ preferences for their own care at the end of life. Most had an advance directive. The overwhelming majority did not want cardio-pulmonary resuscitation, dialysis, major surgery or PEG feeding. They were unanimous in their enthusiasm for analgesic drugs. The uncomfortable conclusion of this study is that doctors routinely subject their patients to treatments that they wouldn’t dream of having themselves.

Some opponents of assisted suicide argue that vulnerable groups, such as the poor, the uneducated, and people with chronic physical or mental disability might be susceptible to this kind of death. A 2007 study examined the experience in Oregon and the Netherlands, and found no evidence for this claim. The only group with ‘a heightened risk’ was people with AIDS. I am not remotely surprised by the findings of this study. The passion for control is rare among the ‘vulnerable’.

There is a schism within medicine. Palliative care is trying to return to tame death – or at least a modern variant of it, while oncology is pulling patients in a different direction. Oncology, for all its claims to being at the cutting edge of medical science, has more than a touch of primitive shamanic ritual about it.

And in a war that you cannot win, you don’t want a general who fights to the point of total annihilation. You don’t want Custer, you want Robert E. Lee, someone who knows how to fight for territory that can be won and how to surrender when it can’t, someone who understands that the damage is greatest if all you do is battle to the bitter end.
Oncology, unfortunately, has more Custers than Lees.