David Brooks has a column in today’s NYT that offends on several levels. But I want to focus here on the prejudicial language he uses to describe people with quadriplegia. From his column:
Life is not just breathing and existing as a self-enclosed skin bag. It’s doing the activities with others you were put on earth to do.
How can anyone in good conscience and with love in their hearts for their fellow man call anyone a mere “self-enclosed bag of skin,” as if their lives were no more important than a purse? Awful. I hope he is merely thoughtless in his choice of words. But imagine the hurt of being a person with quadriplegia and reading those words. As my friend Bob Salamanca, who died of ALS, once despairingly said about such advocacy, “They are pushing me out of the bright lit avenues and into the dark alley [of death].” Moreover, we aren’t what we can do, but who we are.
Brooks segues from disparaging people living with serious disabilities and long term morbidity into the promotion of what could be called a moral duty to die for those whose care costs a lot of money. If anyone is interested in my take, I discuss in some detail over at Secondhand Smoke.
July 15th, 2011 | 12:49 pm
Brooks starts from wrong place (what can government-based health-care do?), which means in trying to find the answer (not as much as people want it to do) to this wrong question he gets to a very, very wrong place (let’s dehumanize old, sick people!).
July 15th, 2011 | 2:12 pm
[...] Reno Rob Saler Russell E. Saltzman Matthew Schmitz Kevin Staley-Joyce « Previous |Home| re: Death and [...]
July 15th, 2011 | 2:54 pm
[...] first thought on reading the emerging discussion on David Brooks‘ column is: Obviously Brooks is thinking through the [...]
July 15th, 2011 | 4:47 pm
When I consider victims of ALS, the most prominent is Professor Stephen Hawking, who made many of his most significant scientific contributions to the interplay of quantum physics and cosmology at the point when he had lost most of his physical abilities and become “a bag of skin”. He speaks with a special system that lets him choose words from a computer screen by looking at them, and those of us who enjoy watching science programs on PBS, the Science Channel, National Geographic Channel, and the History Channel, are familiar with the computer- synthesized voice his system produces. He has just published a new book.
Among the recent scientific news are studies of brain activity using scans such as Positron Emission Tomography that reveal brain activity in patients whose conventional Electro Encephalograms (EEGs) appeared to be just random noise. And other studies of persons who have revived from comas after years of appearing to be almost dead has found that many of them had conscious brain function during that time and retain memories of things said in their hearing.
We should be extremely wary of deciding that a person’s inherent value to himself can be determined by what we outsiders observe in a casual second. The human mind is much more resilient and persistent than we can presently appreciate. Denying water and nutrition to people, just because they are incapable of saying they need it, is now revealed to be a terrible cruelty. And anyone with a Christian conscience needs to work to ensure that the laws are changed to protect the people who are entrapped within their bodies.
July 15th, 2011 | 10:03 pm
How can anyone in good conscience and with love in their hearts for their fellow man call anyone a mere “self-enclosed bag of skin,” as if their lives were no more important than a purse?
How can anyone be so dense as to not understand that Brooks is writing out of sympathy for the people he describes? Moreover, he does not say or suggest that their lives are unimportant. Nor does he in any way disparge anyone, not any more than Dudley Clendinen himself does.
It’s blog posts like this that make me cynical about the Religious Right. If you’re trying to preach the gospel, begin by loving the people you’re preaching to. If you do that, you won’t so badly misread their hearts.
July 15th, 2011 | 10:10 pm
Brooks starts from wrong place (what can government-based health-care do?)
Actually, no. Anyone with basic reading skills not starting from ideology can see that Brooks starts from the wishes of a man for whom the choice of whether to die or to live with a horrible disease is not academic like it is for . . . for you?
July 15th, 2011 | 10:24 pm
It’s interesting to note that in the same article Brooks recommends Born Toward Dying, by Richard John Neuhaus.
July 15th, 2011 | 10:34 pm
Also, I agree that “self-enclosed skin bag” is insensitive, but so is “vegetable”, and that term is in common use. Maybe we all could stand to be a little more sensitive when we talk about these things. You know, specks and logs and all that.
July 16th, 2011 | 1:55 pm
Also, I agree that “self-enclosed skin bag” is insensitive, but so is “vegetable”, and that term is in common use.
I think both terms are fine as long as they’re used as descriptors, not insults. We need accurate descriptions.
Maybe we all could stand to be a little more sensitive when we talk about these things. You know, specks and logs and all that.
If that’s directed at me, point taken. I stand by my criticism, but I should have used a milder tone.
July 16th, 2011 | 3:27 pm
I’m not sure how sympathetic Brooks is. Notice he’s more “we need to get used to death” than “we should change our health care system so they don’t need to make a Hobson’s choice based on finances?”
The problem is that we aren’t serious about getting the costs down. Maybe we can make it so a trach and life support doesn’t cost 500k a year. Maybe we can subsidize research or drugs better so they don’t cost 14k. Brooks has a national pulpit to stimulate discussion over this. But he instead just reflects the fatalism of the educated NYC class more concerned about protecting their stations.
July 16th, 2011 | 4:23 pm
Dblade, you present zero evidence that Brooks is concerned about protecting his station, nor how the views in his column would help him do so. He doesn’t need to start a discussion on reducing the cost of health care procedures – that’s hardly a newly identified problem.
July 16th, 2011 | 4:48 pm
But he instead just reflects the fatalism of the educated NYC class more concerned about protecting their stations.
Dave,
A. Don’t pick on us educated New Yorkers!
B. I hope we hear more from David Brooks on this (and I trust we will), because I think he is not saying quite what people are taking him to say. He is a person of good will, and I have enough faith in him not to be disillusioned by one harsh sounding sentence. I don’t think he is saying that severely disabled dying people are self-contained bags of skin if there lives are, or can be made to be, worth extending. I do think he is saying that death is not something to be staved off at all cost to society and to the dying person. Two months of dying with good palliative care may be far preferable to four months of dying with aggressive medical treatment. I think many people might prefer to die a bit sooner in the comfort of their own home than prolong their lives by spending their last days in a hospital.
I don’t even think you need to bring religion into the discussion to maintain that the point of living is not staving off death for as long as possible at all costs.
I had a friend whose father had an inoperable brain tumor, and he just kept getting worse and worse. He didn’t really know what was going on. He didn’t recognize the family. The tumor was causing his head to become misshapen. It was a nightmare for everyone involved. His heart stopped, someone called 911, and paramedics came and revived him. What was the point? There comes a point where it’s time to let go. Sometimes it’s difficult to decide when, but sometimes it’s not. I read (and wrote) recently about a drug treatment for prostate cancer that cost $93,000. In trials, those who took it averaged about 25 months of survival and those who got a placebo survived an average of about 21 months. Medicare pays for it, so the cost to all of us for those who get the drug is $93,000 for an extension of life for 4 months. That may be worth it, but what if was 1 month? Or 2 weeks? We can’t just pretend that money is not a factor.
July 16th, 2011 | 5:42 pm
If that’s directed at me, point taken. I stand by my criticism, but I should have used a milder tone.
I wasn’t directing it at you, specifically, Ken. I really meant all of us, including me. This is a touchy subject, and there are a lot of raw emotions involved. Case in point: David Brooks. It’s unusual to hear him use a term that could be so easily taken as an insult. His strong feelings about the issue no doubt kept him from realizing how offensive that term might be to others. Normally, he’s more sensitive than that. I imagine by now he wishes he would have used another expression. For as you said, the rest of the article shows that he meant no disrespect.
July 17th, 2011 | 1:28 am
Ken. read his books and columns. The man is called a conservative, but he is a statist mostly focused on navel-gazing on his BoBo class. He’s the male Peggy Noonan.
To complain about accepting death and try to link it to budget woes is a sign of someone who doesn’t want to encourage hard change. And no, you don’t just hand it off to someone else. When someone writes an article about choosing death due to a large part cost, I think its fair to expect a little anger or demanding an accounting of the system that does so.
Dave:
A: Oh god, that class needs picking on, although not you personally. Because they tend to dominate media. They don’t realize how different life is outside of the bubble. But that would lead into an epic off topic rant.
B. No. Not until we sit down and try and fix costs. We need to look at why its $93k for that drug. Once we’ve tried to mitigate that, then we can talk about quality of life issues.
My point is that we can’t say “we shouldn’t prolong care” without trying to fix what is a busted health care system. The right response is getting angry, because we need to do things. if we embrace a “care is futile beyond a certain point” mentality we are capitulating to a busted system rather than trying to change it.
It’s not the right spiritual attitude for this time.
July 17th, 2011 | 11:32 am
I think both terms are fine as long as they’re used as descriptors, not insults. We need accurate descriptions.
How about “masses of cells” or “lumps of tissue” or “useless eaters”?
July 17th, 2011 | 1:40 pm
Dblade, Brooks has had plenty to say about the health care system in general. He can’t just write one more column and fix it, and he can’t just write a column and invent more effective medical procedures for prolonging a high quality of life. What he can do is ask people to be realistic.
July 17th, 2011 | 3:29 pm
My point is that we can’t say “we shouldn’t prolong care” without trying to fix what is a busted health care system. —Dblade
I agree with your main point, here, but the claim that “we shouldn’t prolong care” isn’t really what Brooks was saying, right? That makes it sound as though he was proposing a policy. I understood him, instead, to be appealing to individuals to re-think the wisdom of requesting extraodinarily expensive resources at the end of their lives for little more than the promise of a few extra weeks of pain and suffering, especially since there isn’t enough money to cover everyone’s medical needs.
P.S. I notice that you’re now posting as “Dave ‘Dblade’ Dutcher”. Don’t tell me you let Joe Carter “disrespect” you into abandoning your anonymity. ;) You know that’ll just encourage him.
July 19th, 2011 | 7:39 am
But he instead just reflects the fatalism of the educated NYC class more concerned about protecting their stations.
Dave,
A. Don’t pick on us educated New Yorkers!
Right, because being “educated” is exactly what being “more concerned about protecting their stations” is all about.
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