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This morning I awoke to this very caring—yet disturbing—column (“Searching for Dignity in Old Age” published in the Tampa Tribune), awaiting perusal in my e-mail. Real estate developer Jim Dyal writes movingly of his intense grief at the increasing debility and dementia of his mother and mother-in-law. That he loves these women cannot be doubted. But the piece also contains an undertone that vividly illustrates the acute dangers that can result from the most well meaning of concerns toward the debilitated elderly, seriously disabled, and terminally ill in our increasingly utilitarian society.

Dyal writes movingly of the declining health of his mother, who had to have a leg amputated:

She can’t walk, can’t perceptibly talk, can’t feed herself, can’t dress herself and has no prospect of ever being able to do those things again. The trauma, anesthesia and multiple medications have deepened her descent into dementia. A woman with a master’s degree in guidance education who spent 30 years teaching and counseling in the Hillsborough school system, who was an avid Buccaneer and Gator fan, and who could ardently debate you on any political topic, now stares blankly at the TV.
At the same time, Dyal’s mother has Alzheimer’s:
We brought her a homemade pumpkin pie for Thanksgiving. She ate a piece and said how good it was. Then, 30 seconds later, she saw the pie and asked, “What kind of pie is that?” Her entire savings, even with medical insurance and Medicare, is gone, and we have had to apply for Medicaid.
As we shall see, in his grief, Dyal seems to support the idea of putting people who have lost most capacities out of their misery because they have no remaining human dignity. But that’s not true: Their dignity is inherent. We are the ones who sometimes can’t see it any more because we live in a culture in which independence and achievement are accepted as the be all and end all. Moreover, I argue that it is from our very love and devotion to them—even at the cost of the intense pain of seeing our parents so profoundly compromised—that we can”find” the human dignity that may seem to have been lost, but remains, albeit in a guise that may be more difficult to see.

Dyal concludes:
Their physical condition, for the most part, is not too bad. Their hearts are fine, as are their lungs, liver and kidneys. They could live in their conditions for years.

Medical science has made such great strides in improving medical care, but somewhere along the way, I think we forgot to improve the quality of life that goes with longer life spans. We have given them a healthier future, but at the expense of their dignity.

As my tearful wife so aptly put it, “I would never let my dog suffer the way my mother has.”
And therein lies the danger. Dyal seems to believe—without explicitly so saying—that euthanizing the debilitated elderly is a proper answer to their alleged loss of dignity. For that is precisely where his thought trajectory leads. And if followed, it will eventually result in excavating a perceived moral gulf separating “us” from the “them,” creating a society where we could rationalize putting the old, the infirm, the expensive for which to care, and the dying out of our misery. And indeed, that is precisely what is happening today in the Netherlands.

I understand Dyal’s anguish, his thinking, and the reasons for both. I empathize and sympathize with his pain. But his implied solution must be resisted. It is the infamous road of good intentions that leads to the worst of destinations.

P.S. For those who might write that I could never have faced such a dilemma in my own family: I lost my uncle to Alzheimer’s in December 05. I know exactly the heartbreaking difficulties about which Dyal is writing.

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