From the October 02, 2005 New York Times, a clear eye toward the
implications of an aging society from a pundit (who usually irritates me
with his right-wing proclivities disguised as moderation). - DC David
Brooks : Longer Lives Reveal the Ties That Bind Us.
Let me tell you how
we're going to die. Twenty percent
of us, according to a Rand Corporation
study, are
going to get cancer or another rapidly
debilitating
condition and we'll be dead within a year
of getting
the disease. Another twenty percent of us
are going to
suffer from some cardiac or respiratory
failure. We'll
suffer years of worsening symptoms, a few
life-threatening episodes, and then
eventually die.
But 40 percent of us will suffer from some
form of
dementia (most frequently Alzheimer's
disease or a
disabling stroke). Our gradual, unrelenting
path
toward death will take 8 or 10 or even 20
years,
during which we will cease to become the
person we
were. We will linger on, in some new state,
depending
on the care of others.
As the population ages, more people will
live in this
final category. Between now and 2050, the
percentage
of the population above age 85 is expected
to
quadruple, and the number of people with
Alzheimer's
disease is expected to quadruple, too.
The President's Council on Bioethics, under
Leon Kass,
who stepped down yesterday as chairman, has
been
trying to grapple with what this means. The
council
considers the practical issues. We don't
have enough
people to take care of the millions on the
glide path
toward death. Fewer people go into nursing.
Families
are smaller and divided.
But the biggest issues the Kass report
takes up are
moral and cultural. We live in an
individualistic
society. We think of ourselves as
autonomous
creatures, making up our own minds and
seeking
self-fulfillment.
That was fine in an earlier age, when kids
could go
off at age 16 to make their way in the
world, and when
people died at age 65 after a short
illness. But as
the Kass report notes, ''The defining
characteristic
of our time seems to be that we are both
younger
longer and older longer.''
Parents have to spend a lot more time
preparing their
children for the new economy and children
have to
spend a lot more time caring for their
parents when
they are old.
In other words, technology, which was
supposed to be
liberating, actually creates more
dependence. We spend
more of our lives while young and old
dependent upon
others, and we spend more time in between
caring for
those who depend upon us.
Will our moral philosophy catch up to this
reality?
When George Bush delivered a speech on the
ownership
society, Peter Augustine Lawler, who is a
member of
the bioethics council, wrote an essay in
The New
Atlantis called ''The Caregiving Society,''
chiding
the president for offering an overly
individualistic
social vision. ''The ownership society only
makes
sense if it prepares us to be care-givers
and
care-receivers,'' he wrote, ''and if it
does not
encourage us to see ourselves as
unencumbered
individuals.''
Lawler argued that the ethic of ''mutual
neediness
should limit the idea of self-ownership.''
He cited
the French philosopher Chantal Delsol, who
observed
that the ''amount of vigilance, care,
friendship and
patience that must be given any person, if
he is not
to be driven insane or to despair, is
almost literally
incredible.''
The council report is very much in this
vein. It is a
rebuke to the economic individualism of the
right and
to the moral individualism of the left.
With its
emphasis on mutual obligation, I sometimes
thought I
was reading a report from the old German
Christian
Democrats.
The report argues strongly against living
wills and
advanced directives, against individuals'
attempts to
control their own treatments and deaths. It
is more
ethical and more effective, the council
believes, to
give a loved one the power of attorney to
make medical
decisions for you, and so acknowledge your
own
dependence.
The report questions the foundation of
individualism,
that our worth is determined by what we say
and do.
No, the report says. Our worth is in our
bodies, and
our relationships. As Kass put it the other
day, ''The
much diminished mother I hugged on the day
of her
death was the same woman I'd been hugging
all my
life.''
The report also shows how far social
thinking has
moved in the past 30 years. A generation
ago, all the
emphasis was on rebelling against
conformity, on
liberating the individual. Now the emphasis
is on
nurturing bonds so sacred they are beyond
the realm of
choice. Now the individual is less likely
to be
regarded as the fundamental unit of
society. Instead,
it's the family.
In a mobile, high-tech age, the Kass report
is a
declaration of dependence. |