Not all cultures have this attitude. Look at the Mexicans, with their annual "Day of the Dead". At our Hallowe'en time, they dwell on death, in what some people would call a morbid way. But they make fun of it, demystify it, with candy skeletons and cookie death masks. This approaches a cult of the dead, in sharp contrast with our avoidance of the dead.
In Europe, where the wearing of black is a sign of mourning, some older women have all-black wardrobes, as someone in their entourage is always dying. Men show their respect less conspicuously with black arm bands.
Why are we American so different? One reason is the attitude of our medical doctors. We already look up to them with exaggerated deference. When we see "Dr" in front of someone's name, we automatically assume it refers to a medical degree. We treat them as authorities, not to be questioned. It is therefore not surprising that the prestige we attach to them spills over into adapting their attitude toward death. As savers of life they are taught to see death as their enemy. Whenever they can save a life, no matter at what cost, they claim a victory in the never-ending battle between life and death. It's no wonder we take over this attitude, without thinking.
In addition, as a still-young culture, we worship youth. Old age and dying are not valued. No wonder we try to hide evidences of age and accompanying failing health, by resorting to Botox, plastic surgery, hair pieces.
The economic consequences of this attitude can be felt in our approach to health care. As we are gradually reaching the conclusion that universal, single-payer insurance is the only feasible, affordable way to counter ever-rising health care costs, we find a large stumbling block in our path: our "don't touch" attitude toward severe illness and dying. Instead of prolonging life at exhorbitant cost, we will be obliged to ration end-of-life treatment. The word "ration" scares people. But health care is already rationed, in an "irrational" way: those who can afford it obtain the best care, and live long. The poor take an aspirin, and die young.
"Rational" rationing uses money on preventive care, prevention and early treatment of large-scale illnesses, like malaria, malnutrition, AIDS. care according to need. Spending thousands to keep one nonogenarian alive will be eliminated. This may seem hard-hearted. But I just turned 93. I have signed documents stating that I do not wish heroic measures to be used in order to prolong my life.
As a society we must overcome our reluctance to face dying and death, not think of them as enemies, but as friends. If, as Hospice has discovered, using palliative measures to reduce pain can help make the dying process be a time of reflection, reminiscing about old times, mending relationships if necessary, preparing for death in a peaceful way.
Only when we have overcome our fear of death will we achieve truly universal health insurance.
4 comments:
I had never connected a fear of death with the rising costs of health care before. Thank you for another thought-provoking post.
You are right: health care is already rationed in the U.S. I like the idea of "rational" rationing.
Very interesting! I'm a strong supporter of single-payer universal health care, but I am also, I must admit, afraid of death. I think it's important for those of us who support single-payer healthcare to be honest about the "downsides," or at least changes in perspective required.
I think we need to look at the other end of the spectrum as well. Does it make sense to spend thousands of health care dollars on heroic measures to save the lives of tiny infants born three months prematurely when there are already millions of orphaned and malnourished children in the world? In the past, before we had such advanced technology, these infants would have died.
However, it's important to remember that any rationing in health care will never apply to the wealthy. Rich people will always be able to obtain whatever health care they want, even when they are 100 years old.
Post a Comment