The Victorian poet Arthur Hugh Clough offered an update of the Ten Commandments. Some of his verses are merely neat, for example: “Do not adultery commit,/Advantage rarely comes of it.” Others are more to the point: “Thou shalt not steal, an empty feat/When it’s so lucrative to cheat,” advice taken to heart and acted on by a number of rogues in the City of London and on Wall Street.
One of Clough’s new commandments is very relevant to our time: “Thou shalt not kill, but needs not strive/Officiously to keep alive.” The old commandment—“Thou shalt not kill”—is generally observed in civilized societies. Homicide is wrong. We almost all agree about this. Clough’s revision is of course humorous, but it bears thinking on.
Every country in the West and some, such as China, in what we used to call the Third World is faced with the problem of an aging population. Life is being extended far beyond the biblical “threescore years and ten.” But prolonging life doesn’t necessarily prolong pleasure; quite the reverse. Last year Alzheimer’s and other forms of dementia became the chief causes of death in England and Wales, responsible for 11.6 percent of all deaths. There are cases of early dementia, but characteristically it is a disease of old age. As medical science prolongs life, the prospect of dementia looms. I know nobody who isn’t horrified by the thought of developing dementia, and likewise nobody who isn’t dismayed by the prospect of having to care for a demented spouse or parent.
So what’s to be done? Medical science is like nuclear weapons, which once invented can’t be uninvented. Likewise the march of science will continue. Few of us, I think, are in favor—yet, anyway—of euthanasia or so-called mercy killing, and we recognize that it’s wrong to ask doctors, dedicated to saving life, to take the responsibility of ending it. Withdrawal of treatment in certain cases is another matter, one that meets with considerable approval.
Moreover, it’s not only the dreadful prospect of dementia that concerns us. The prolongation of life brings with it social and economic problems, too. The burden of providing care for the elderly in form is a heavy one, and going to get heavier. It puts an enormous strain on hospitals and social services. And here we come back to Clough’s wry comment; we are indeed striving officiously to keep alive old people, for many of whom life has lost its savor.
So what’s to be done? It may be that we are looking at the problem through the wrong end of the telescope. The problem is less old age itself, with all its admired horrors, but the number of people living long enough to be consigned to care homes, hospital wards, or the mindlessness of Shakespeare’s seventh age of man—“second childishness and mere oblivion,/Sans teeth, sans eyes, sans taste, sans everything.”
Well, the advances in medical science that have made greater longevity possible are going to continue. But it is not only medical science that has prolonged life. Social and fiscal policy has made its contribution. For years governments, egged on by doctors and other health professionals, have made war on two social habits that in the past frequently shortened life. The war on alcohol is still in its early stage, but it is already more than a phony war. Social pressure as well as high taxation are having an effect. The four-martini lunch is a thing of the past, and one reads that on the whole young people today drink less than previous generations. So they are less likely to die of alcohol-induced heart attacks or cirrhosis of the liver. They’ll live long enough, poor things, to develop dementia.
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