Monday, 23 September 2013

Empowerment of endings

Last week, just before he was cut short by the intractable problems that the Today programme has with its telephonics, David Attenborough said that 'old age is not for sissies.'

Rather than be affronted that an interview that was supposed to centre on his new show was inelegantly redirected towards euthanasia and quality of life in old, he expressed great temperance and dignity in beginning to address the issue. The phone line dropped before he could make his full point, but it was ramping up to be considered and eloquent.

His qualification for questioning on the issue was predicated on the fact that he is old. But he did not pretend to be an expert. In fact, he seemed a little bemused. He is after all in very good health, and sustaining an enviable professional output. For him, the issue of frail old age may well be as distant to him as it is to us, as it is simply not his experience of the world.

It can be difficult to empathise with something of which you have no direct experience, and what he did so well was to illustrate the need for circumspection. There is no right or wrong answer in the issue of euthanasia in old age (for that is what Justin Webb was rather insensitively asking him about). In fact, most of the headline cases of people seeking assisted suicide involve younger individuals with predictable progressive neurological illnesses, for whom the manner and timing of their own deaths is the last defiant act they can take, towards a disease that has robbed them of so much.

By asserting that old age is not for sissies, David Attenborough made exactly this point. Your individual reaction to the aches and limitations of old age is not predetermined, and it is not universal. There can be no universal answer to the problem of what we should do with or for our frail and elderly.

He is a good example of what good old age looks like. He is also an example of how well the elderly can do when they have purpose, respect and opportunities. Often the discussion around euthanasia and the elderly takes place in a climate of negative assumptions about the role that they have in society. The question of whether the elderly should have access to assisted suicide, or the right to die, is perhaps underlined by the implication that they have no broader role in society, and the implication that the best that we can offer them is the choice of when they die.

The question will always remain, and it will always remain a matter of collective judgement and value. I repeat, there is no right answer. But there is a sense in which we are still not ready to progress the debate: the risk of allowing assisted suicide or euthanasia is the risk that individuals will be coerced, in a variety of ways, both well-meant and sinister, to end their lives when they would not have otherwise done so.

This risk would be tempered if the role of the elderly in the day to day functioning of society was more embedded. David Attenborough may be in his late 80s, but we all respect the work he has done, and continues to do. But is his success the product of some rare talent that he has, or is he simply the rare individual who has continued to have opportunities, where other elderly folk do not.

Until we can satisfy ourselves that the role of the elderly in society is better embedded, and that their participation in the communities and the work place is limited only by their ability or willingness to take part, then I would rather see the discussion centre on how we can involve them more, not on how we can help them end their existences.

The issue here is one of empowerment. Euthanasia and assisted suicide are issues that have at their heart the empowerment of an individual who is losing, or has lost, their reason to live. A discussion around its application to our elders can only meaningfully take place in a society that has done all it can to empower those individuals who are experiencing the waning of their physical and cognitive abilities. Until we can satisfy ourselves that this is something that we do well, then further discussion is premature. I worry that the repeated emergence of the euthanasia debate in the media portrays our collective ambivalence to the role of the elderly in the smooth functioning of society.

I have no doubt that the kindest action we can take right now for our frail elders is to involve them better in the decisions around their medical care, while at the same time working tirelessly to involve them better in the daily functioning of our communities. There must be a great many David Attenborough's out there who are not given the chance to shine.

Old age is not for sissies, partly because it can be tough, but also because we make it tough.

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