The terrible price of longevity

Here’s an incredibly powerful and superbly written account from the New York Times about the consequences of life-extending interventions by medics.

It begins:

One October afternoon three years ago while I was visiting my parents, my mother made a request I dreaded and longed to fulfill. She had just poured me a cup of Earl Grey from her Japanese iron teapot, shaped like a little pumpkin; outside, two cardinals splashed in the birdbath in the weak Connecticut sunlight. Her white hair was gathered at the nape of her neck, and her voice was low. “Please help me get Jeff’s pacemaker turned off,” she said, using my father’s first name. I nodded, and my heart knocked.

It’s a gruelling read, and worth every word. You can find it here.

Cash for corpses

You can tell how developed a society is by the price it puts on life. Could, rather. In the most developed societies there’s a re-evaluation going on. The Office of National Statistics calculates that death is now preceded by the unendurable prospect of an average 10 years’ chronic illness or dementia. It scares the hell out of us. No one wants to go there.

So there’s a national conversation about assisted suicide and self-deliverance. We read about Debbie Purdy and lovely Omar and we say, “If that was me… Yes, of course she should be allowed to. It’s what I want for me, too.”

What price life, now?

What price keeping all our old people alive, too? Can we afford it? Can we not incentivise them in some way to sign up to an accelerated end-of-life care plan? Yes, we’ve got ADRTs, a thin end of the wedge, but something faster? Because if we don’t, there’s going to be a heck of a doubly-incontinent lot of them when the baby boomers start their final, slow descent. And I don’t know who’s going to look after them. And I don’t know where the money’s going to come from. No one does.

So we’ve identified a brand new human right: the right to die. There’s been remarkably little fanfare about that.

But with rights come responsibilities. Have not the old a duty to vacate the stage, leave the building?

We’re getting our heads around it, this de-sanctification of human life. We’ll get our heads around the eu-word. We’ll have to. We have our abortions, after all.

So it’s interesting to see the Nuffield Council on Bioethics talking today about ways to incentivise organ donation. In the words of Management in Practice:

Under the Nuffield Council on Bioethics’ plans, organ donors would be put on a transplant priority list and their families would be helped with funeral expenses.

The priority list proposal would see donors at the front of the queue for kidney, heart and other organ transplants, while contributions would be made to the funeral expenses of dead donors’ relatives.

Financial incentives, “presumed consent” systems, personal “thank you” letters and certificates and souvenirs such as T-shirts and mugs could also be considered. The financial incentives may range from payments to the regulated selling of organs, eggs or sperm and a fully-fledged free market or just modest expenses.

Today’s Guardian quotes Dame Marilyn Strathern, professor of social anthropology at Cambridge University, who is leading the consultation working party: “We could try to increase the number of donors by providing stronger incentives, such as cash, paying funeral costs or priority for an organ in the future, but would this be ethical?”

Ethical? Cash for corpses? Leave it out, Dame Marilyn. You are the future.