David Brooks’ column today on life and death is thought-provoking but ambiguous at several important points. It’s not clear whether, along with Dudley Clendinen, Brooks denies the value of life with diminished capacities or whether he simply thinks patients should sometimes choose to forego costly and uncertain treatments. (This ambiguity is part of why I think Wesley is too quick to fault Brooks for demeaning the ailing or building a case for death panels.)
As Wesley reminds us, the former view is dangerously mistaken. However, the latter view is both necessary and wise. As Ryan Anderson writes at National Review:
One can recognize that rising health-care costs, particularly at the end of life, are bankrupting our nation and thus failing to serve the common good without concluding that this entails that the lives of those with terminal diseases are no longer worth living. Between the two extremes of intentionally killing and prolonging life at all costs lies a virtuous mean of accepting death when the alternatives prove disproportionate.
In fact, this is just what Pope John Paul the Great, in his last act of public teaching, taught the world as he humbly accepted his death — neither deeming life with Parkinson’s disease unworthy of living (and thus killing himself) nor demanding every life-sustaining treatment (irrespective of cost, likelihood of success, and alternative uses for scarce resources).
Like Ryan, I wish Brooks had clearly affirmed the value of the lives of the seriously impaired and terminally ill. This affirmation will have to be central if we are to responsibly reckon with swelling health-care costs.
July 15th, 2011 | 2:37 pm
I agree that Wesley J. Smith was too quick to fault David Brooks. I don’t think Brooks is saying that a severely disabled person is merely a “self-enclosed skin bag.” I do think he is saying that serious thought needs to be given, by everyone (the sick and the medical establishment), to the idea that life must be prolonged to whatever extent medical science can achieve, with no thought given to expense or quality of life. I don’t think Brooks would say that Stephen Hawking is a “self-enclosed bag of skin.” But for an athlete or a dancer or a painter, the physical limitations that Hawking endures might be worse than death.
It is unfortunate that Dudley Clendinen brought up suicide, since almost certainly all he will need to do is forego treatment when he reaches the point where he finds life intolerable. And that is everyone’s right who is dying or whose health is in serious decline, and it’s not suicide.
July 15th, 2011 | 2:58 pm
[...] Reno Rob Saler Russell E. Saltzman Matthew Schmitz Kevin Staley-Joyce « Previous |Home| Humanity, [...]
July 15th, 2011 | 8:37 pm
I think I know what Smith is doing, though. If Brooks had said “the kind of life that would be intolerable for me,” that would be one thing. But he chose to use language that implies objective intolerability — that no reasonable person could be expected to tolerate such a situation, and that in fact, there is no humanity really left to tolerate it. And in our current climate, that’s just dangerous, because it promotes an idea that some things are objectively intolerable and not really living anyway, which means no person should be expected to tolerate it, which then naturally leads to “allowing people to tolerate it is cruel, and hey, they’re not living anyway.” I don’t think Brooks *means* to build a case for death panels, and I don’t know that Smith thinks he does. But if the effect of the language is to give aid and comfort to something, then the language needs to be criticized.
July 16th, 2011 | 8:55 am
I’ve only read the Matthew Schmitz post on this, but even the Ryan Anderson quote doesn’t sit well with me. He writes:
There are both political and theological problems with this. The political problem is that as we move inexorably closer to socialized medicine we have seen healthcare prices skyrocket to the point where no one can afford to pay (thus ensuring an ever more socialized system), as opposed to an entirely fee-for-service system where by definition nearly everyone must be able to pay, or very few get paid. Neither system is perfect, but when we start evaluating our personal heath treatments based on whether we might bankrupt the nation, then we’ve thrown our lot in with socialized medicine.
Our bodies are not for the good of the state, but neither are they strictly our own: they belong to Him who created us and to whom we are meant to return, which brings me to the theological point.
A life worth living is not a matter of proportion. For Anderson, this “virtuous mean” is a cost-benefit analysis between the individual and the state, and certainly Pope John Paul didn’t conduct the analysis Anderson suggests. Rather he made a decision not to take extraordinary measures to prevent his final return to his Creator.
July 17th, 2011 | 11:04 am
[...] As a former hospital CEO, it seemed clear that the medical schools had taught the Northern European philosophy that “Death at any time is failure.” It seemed that the very reality of our mortality was overlooked. Having had responsibility for funding a palliative care unit in my last hospital, it struck me as sad that the vast majority of patients being admitted there arrived for the last week, day or few hours of life, and the “life extending measures that had be foisted upon the patient and their families” prior to that time neither reversed the disease nor improved the quality of their lives. Unfortunately, some of this is about income for the provider, but most of it is about our inability to face the end of our time here on earth. [...]
July 17th, 2011 | 2:44 pm
Nick Jacobs, thanks for linking your essay to this post. Everything you say there needs to be heard and acted upon. In particular, your reference to something Governor Lamm said needs to be repeated until it finally sinks in:
According to Lamm, this generational robbery [of medical resources] has contributed to produce one of the highest infant mortality rates in the civilized world and has provided the resources allowing our seniors to squeak out another few months or days of life.
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