Thursday, April 21, 2016

Keeping death at bay

I've never seen this discussed–which doesn't mean it hasn't been–so I will discuss it myself. Let's begin with a preliminary observation:

i) To my knowledge, the human body typifies planned obsolescence. Almost as though the body has an auto-destruct that triggers after it runs a fixed number of cycles. Each body has a natural lifespan. And that varies from one body to another. Jeanne Calment didn't live to be 122 because she was a health nut. Rather, it seems like the rate at which she aged was slower than for most folks. 

I think human bodies are programmed to shut down at a certain age, although the program varies from one body to the next. Of course, it's not quite like a switch with a timer. Behavioral and environmental factors affect longevity. 

But there's a sense in which the body is programmed to self-terminate. That's internal to the body. Each body's inbuilt lifespan. 

ii) Now, one kind of life-extension is counterfactual. There are external factors, like pathogens, that can prevent the body from completing its natural lifespan. Take an illness that will shorten the life of the patient, absent medical intervention.

In that case, medical intervention counteracts the attack from outside forces. It restores the body to normal functioning, as if the patient was never sick in the first place. Resetting the status quo ante, so that a body will continue enjoy the longevity it was internal programmed to have. That kind of intervention prevents premature death. Keeps a body from dying "before its time". Let's call that natural life extension. 

iii) Another kind of life-extension prolongs the body's longevity beyond its natural lifespan. Like resetting the timer on the auto-destruct. It impedes the aging process. This can involve medication, oxygen, surgery, transplants, implants, &c. Let's call that artificial life extension.

The difference between between the two is that natural life extension blocks something that interferes with natural longevity while artificial life extension interferes with natural mortality. 

A potential problem with artificial life-extension is that a body continues to age.  Like pushing the car's temperature gauge into the red zone. Organs continue to wear out. Organs and systems are now aging beyond the body's natural lifespan. That makes a person more susceptible to dementia, macular degeneration, &c. Even if a cure is found for Alzheimer's, if the brain continues to age, a person will still become senile due to brain atrophy. The brain shrinks with age. Because the brain has so much redundancy, you don't automatically become senile. But below a certain threshold, the deficient begins to manifest itself. 

iv) Prolonging life in this sense can generate self-imposed dilemmas. For instance, Hans Küng is flirting with euthanasia because he's going deaf and blind, suffers from osteoarthritis, and Parkinson's disease. Yet he takes 10 pills a day to stay alive. 

If he finds aging unbearable, why doesn't he just discontinue his medications? Why take pills that artificially prolong life while contemplating euthanasia to end it? 

v) Apropos (iv), to refrain from artificially prolonging your life beyond the body's natural lifespan is not the same thing as suicide. 

BTW, I'm not suggesting there's anything wrong with medical devices that preserve life. Although I oppose transhumanism, biotechnology can be a wonderful tool in medical treatment, both by saving life and enhancing the quality of life. 

In addition, I'm not discussion public policy or bioethics. I'm just making the point that individuals need to consider the tradeoffs and consequences of their personal choices when it comes to prolonging life beyond the body's inbuilt longevity. Both Christianity and atheism have certain tensions in this regard.

In atheism, human life has no intrinsic value. Since, from their perspective, there is no afterlife, some atheists cling to life. Hang on to the last possible moment. Others commit suicide when their best years are behind them and they have nothing much to look forward to.

By contrast, Christians think life has intrinsic value. Yet that's balanced by their belief that this life is not all there is. Indeed, the afterlife will be better. 

3 comments:

  1. Lots of interesting ethical knots here to untangle.

    To my knowledge my life has not ever been endangered to the point at which I would have perished barring medical intervention. I currently take no maintenance or other types of medications. In that I suppose I've been blessed with generally good health.

    Contrast that with my wife, and all four of our children. My wife would likely have died in childbirth with our third because he was breach and ended up being an emergency c-section. This simply assumes she would not have died during the birth of our first two which were normal and uneventful, but this was in a hospital setting with loads of specialists, monitors, etc., along with constant care.

    This also assumes our third would have ever made it to term, which is unlikely, as our second, third, and fourth would probably have died before birth due to the fact that my wife has negative blood and I have positive, and therefore her immune system would have attacked our 2nd through 4th children as foreign invaders (I think that's called rh factor or something).

    Additionally my wife has taken prescription meds for high blood pressure for years, so she might have died from hypertension or heart attack long ago anyway.

    My mother passed about a year ago due to complications stemming from pacreatic cancer. Her life was extended for this year via multiple medical interventions, but the last six months were rather hellish for both my mom, and the family.

    We still ask ourselves if the right calls were made. Was the "extra time" bought "worth it"? How is an approximate value placed on something like that? There's not an easy way to ascribe it.

    And examples and scenarios could be multiplied almost infinitely.

    Gordian knots.

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    1. Oh, and our third had a perforated appendix at three and certainly would have died apart from the exceptional critical care he received at the local children's hospital. Assuming he would have ever made it to term in the first place considering the negative blood type incompatibility problem I referenced before, and the fact that he was breach and an emergency caesarian.

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  2. i) Most, if not all, of your examples, fall under what I classified as natural life extension. These are medical interventions within the natural lifespan of a body. I distinguish that from artificial life extension (as I define it).

    ii) Notice I didn't say artificial life extension is wrong. Just that people need to take into account the tradeoffs and consequences. For instance, you have elderly folks who are understandably terrified by the prospect of dying in a nursing home, yet they avail themselves of medications and medical devices which prolong their life. And, of course, that makes it more likely that they will live long enough to become incapacitated and institutionalized.

    I'm not saying they should refrain from using those medical resources. Rather, I'm saying they need to be consistent. If they don't want to die in a nursing home, even though (in some cases) that's the predictable result of artificially prolonging their life, then they have incompatible objectives, and they need to make a choice. It isn't an easy choice, to be sure.

    iii) There are situations in which an individual has a duty to artificially prolong his life. Say you have an elderly couple in which the wife's health gives out before the husband's. Since she's now dependent on her husband to care for her, he needs to remain able-bodied. If he were a widow, he wouldn't have the same social obligations.

    iv) Terminal cancer is tricky in part because it's always too soon to lose a loved one. You cherish every remaining month, week, day, and hour.

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