End of LIFE for a LOVED PARENT Daniel Callahan Responds Reading Peter Lawler’s interesting paper made clear to me two points. One of them is that I see no fundamental disagreements between us—well, maybe one. Both of us are trying to wrestle with some basic tensions in medicine on end-of-life care, often pitting two goods against each other, looking for the right balance. The other point is that his response helped me to clarify something I have long wrestled with in thinking about death: its place in our community and common life, not just our individual lives. Let me deal first with some quibbles. I do not believe that the motive for terminal sedation is “the convenience of the living.” How can he know such a thing? I understand it as a desperate effort to relieve a patient of otherwise unbearable suffering, a last-ditch effort when all else has failed, and it is misused if it aims at the patient’s death. Contrary to Lawler’s assertion, I believe that “people have a right to live as long as they can,” and I agree with him that there is no “duty to die,” an obnoxious idea I have never held. But the important question is less about rights, I think, than about having a prudent and wise understanding about how far and in what ways we should try to extend our lives in the face of critical illness. What I find missing in Lawler’s response is a view on the place of death in our life as a community, its social meaning and ethical implications. While I suspect he no doubt has some thoughts on that, his response comes across as wholly individualist. “The old,” he says, “have no obligation to step aside for the young, either for the benefit of society or for the benefit of the species.” While I would not use the term “step aside,” I do believe that there are reciprocal obligations between young and old: Each age group has duties toward the other. The young need to provide help and resources to the old when they are sick and infirm, both by their personal help and support of government health care and Social Security for them. The old need to do what they can to avoid harming the young in their need for care and to leave behind them a viable and honorable society, offering them at least as good a life as they had. Some 6 million grandparents in our country care for the children of their children. It is often a shame that they have to do so, but it is to their great moral credit that they are willing to do so. When we think about the future of Medicare and Social Security, we should keep in mind that it will be the young who will pay for that program with their taxes—and at the same time as they are paying the costs of caring for their own children (or, increasingly in the future, when parents with young children will be called upon to aid ailing or destitute parents). Finding a good moral balance there will not be easy. I have argued elsewhere that it is possible to speak of a “complete life,” by which I do not mean having done and seen everything and having all one’s desires fulfilled. But by my age, the early 80s, most of us have a good shot at most of the benefits a human life can bring: children, work, love, travel, friendship. Note that I said “most of.” Can we wish for more? Of course.
Posted on: Mon, 08 Jul 2013 16:24:31 +0000
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