If I had a twin he would be a few years away from turning eighty, and while I’m in moderate good health, he might not be. In fact, many of my contemporaries are in failing health, with all that this means for the health costs to society. All to be expected. People in their seventies begin to focus on the infirmities of age. One colleague, for example, reputed to be a heartless soul, now sports a stent to prove to one and all that he does have a heart after all.
For the rest of society, this adds up to increased health costs and, therefore, we have become a burden. My generation is not used to being a burden, and on behalf of my fellows, I offer my apologies.
At the same time, I think it’s only fair to remind society that I, and working people like me, paid for all the medical advances, drugs, training, techniques and technology which enable modern medicine to do so much to save lives and improve living. Perhaps that’s why so many of us resent the attitude of younger people (especially medical personnel) who think expensive medical care should be reserved for the young. No one is crass enough to say it, and nobody has instituted death panels, but the signals are all there.
“What do you expect at your age?” a doctor said to me when I complained about a shoulder pain.
I told him I expected him to use the same kind of medical expertise and intervention he would use on a person twenty-five years younger. While practitioners are rarely as abrupt and forthcoming as this specialist, this kind of thinking prevails. Insurance plans stop paying for certain medications when a person is a certain age, and the elderly are often ineligible to participate in clinical trials. Heroic measures aren’t always taken, and families of desperately sick older people are told to pull the plug for the “benefit” of a suffering relative.
This is a particularly objectionable aspect of the medical profession. The same condition that would draw every last ounce of effort to save the life of a young person results in somber-voiced conversations about death with dignity for the aged.
Why? Wasn’t there a social contract with those of us who supported medical research, training and facilities through our taxes and otherwise? The fruits of medical science were to be available to all of us – not just the young. And if we aren’t as spry, as independent, and as well kept as we used to be, we still want to live. Whether or not it is inconvenient to others, and whether or not we have become a burden.
No doubt a case can be made for those who want to end the pain and suffering they experience. But why the full court press to glorify death as “quality end of life care”? Some of the puff pieces by palliative care centers could have been written by high-end tourist resorts, down to the fresh cut flowers in every room.
This advocacy of death with dignity is particularly true of the Institute of Medicine (IOM) whose “Dying in America” paper runs counter to its mission to improve health. The IOM, a part of the National Academy of Science, has a mandate to cure, not care. Using the prestige and resources of this national body to extol the benefits of care rather than cure is a distortion of its function and a violation of its responsibility to the American people.
Some of the language of this “Dying in America” paper cuts through all the posturing: