Tuesday, September 20, 2011

Cruel Irony

The Circle of Life, ironically, involves death. There. I said it. Let me put it another way. We are all - without exception - going to die sooner or later. There is no way around it. It is not cruel; it is just reality. The only time we consider an untimely death to have been tragic is if the death involved someone we personally loved though I do also think we collectively weep and mourn (as we should) when a child suffers and dies, particularly at the hands of cruel humans. Strange that with technology (such as it is), we do not consider abortion to be particularly cruel or inhumane but we believe capital punishment to be "cruel and unusual".

At a recent Republican debate, CNN's Wolf Blitzer apparently tried to corner Rep. Ron Paul, R-TX, with a hypothetical question involving a comatose patient who lacked health insurance and whether Mr. Paul would have just let him die. An audience member shouted, "Yes!" to the hypothetical and was later attributed to the Tea Party (whether that audience member was a Tea Partier or not, I have no idea and frankly do not care). In the first place, hypothetical questions are almost always unfair because too much is assumed but not enough is allowed. There are always going to be mitigating factors involved in life-and-death issues as well as medical decisions and choices which must be made. There was too much left on the table, but I would have expected no less from a moderator who actively engages debate participants in a sort of side-bar mini-debate. Mr. Paul was asked that question specifically because he is a licensed physician.

Does it matter? Does a physician have more or less insight into the reality of death than, say, the hypothetical uninsured comatose patient's family? Does society have a collective interest in how or whether the hypothetical comatose patient is treated? Some say yes simply because that hypothetical patient could one day be us or someone we love. What we offer to allow is what we are suggesting we would embrace for ourselves - hypothetically, of course. It is the philosophical Social Contract which simply states that what is good for the goose is good for the gander. We would impose no more or fewer restrictions on "someone" than we would reasonably expect for ourselves. Hypothetically, of course. All bets are off, however, when the hypothetical becomes real and is manifest in our own lives. It is reasonable to allow a stranger to mercifully pass from this life, but it somehow becomes an act of cruelty when it involves someone we love.

I do not propose a hard-and-fast solution to each hypothetical situation, and I cannot suggest there is an appropriate age limit by which to gauge and measure a life worth saving. What I can suggest is that we must first get past our unreasonable, irrational fear of death. We do not have to fall in love with death, but we also cannot ignore its harsh reality. People die every day, and there is no medical procedure or adequate amount of health insurance that will change the certainty of death. We can delay it, of course, but we can never "solve" it because it is not a problem to be solved. There will never be a day in which all persons will live to a ripe old age and die peacefully in their sleep. I think the health care debate will never be real until we first get next to this certain, ironic reality of life.

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