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The International Writers Magazine
: Suviving the Golden Years

James Skinner
Although it may sound as a sequel to the sixties epic, ‘The Inn of the Sixth Happiness’ starring Ingrid Bergman and Kurt Jurgens, it is actually the title of a paper written for a medical conference dealing with the problems of old age. Divided into two sections, the first deals with the constant search of a sound and healthy body throughout life, whilst the second refers to the countdown as man succumbs and reaches his final destiny at the pearly gates. How to protect humanity from unnecessary illness and pain whilst easing the burden of ageing as the elderly approach death is a major challenge in modern medical science. However, the graphics inevitably show that the cost of medical attention, including pharmaceuticals plotted against the process of physical deterioration is exponentially opposite.

In other words, the older we get, the more it cost to keep us alive and well. Although this was the gist of the conference, economics demanded that two other vital elements be included in the equations that were pensions and euthanasia. A great deal has and is being discussed worldwide on all subjects. Let us start with the most obvious one, pensions.

It is now widely accepted that the population in the developed world are living longer and therefore require an increase in income during the years following retirement. Pensions have to be paid out for a longer period of time. So how do we fit the extra money needed so that grampa can continue to play his daily round of golf? Yes, I know! Some smart governments are suggesting that grampa should work longer and therefore cut back on his fairway shots. Others are demanding an increase in pension contributions so that the required capital per person is there to take up the slack. Then we have the added complication of the reduction of payments versus withdrawals on the present system of pension accounts. As years go by there are less and less contributors and more and more benefactors. Throw in stock market mayhem, international terrorism, illegal immigration, third world poverty and the whole scenario will eventually bankrupt all pension schemes throughout the world. So why not kill off a few oldies and reduce the burden?

I have written about euthanasia before, but after seeing a recent Spanish film (it will be presented at the Oscars this year) about a paraplegic who for years was asking to be ‘put down’, the difference between suicide, or murder for that matter, and the right to a dignified death became clearer than ever. The film is based on actual fact and took place here in Galicia, Spain. Although the courts denied the paralytic’s request to die his eventual ‘assisted’ death (he took a dose of arsenic ‘accidentally’ administered by a relative) was never condemned. It made the headlines at the time. Thanks to the film the whole issue has now encouraged a serious debate on the ethics of keeping someone alive against their own will. The question is: is the fight for fitness in old age, sometimes at all costs, in contrast with the right to die, or are we somehow looking at a compliment that, in years to come will allow judges to decide on life or death based on the quality of life as well as economics, which after all, is what the discussion is all about?

What is meant by quality of life anyway? Barring leisure, financial and professional success, family happiness and other nice objectives, quality of life is directly related to physical fitness and freedom from disease. This is a very simple analysis, but the non-governmental agencies and other international do-gooders continue to remind us that the majority of humanity still live in poverty and thus have no quality of life at all. Whilst on our side of the fence, modern living takes a toll on our early physical and mental fitness. Unless we have looked after ourselves, that so called quality of life will in later years, crumble before our eyes. In fact, very few human beings on this planet, rich or poor go through life without some sort of a hiccup that threatens the utopia of a lifetime of well being. A quick look at the encyclopaedia of the most common diseases and a check at world statistics will reveal that the vast majority of humanity, at one stage of their life will suffer from something that will rush them to the nearest doctor. But the medical report was referring to the specific case affecting the third age. Third age? What is it and where does it start?

Some pundits consider grey hair as the beginning of the end. Others reckon that the final pink slip from the boss is sufficient proof for reaching old age. There are thousands of physical reasons ranging from loss of memory (not always due to Alzeihmer’s disease) to sleeplessness, from lack of energy during a stroll in the park to switching off the television before the 9 o’clock news. The threshold can therefore vary from 50 to 100 years of age. Despite these symptoms, the old body machine can still tick without a screw coming lose, provided the technicians continue to oil the bearings (change a hip joint) and polish the brass knobs (give a breast implant). This is precisely the description of quality of life. Yet according to the Socrates oath taken by the medical profession, every effort should be made to keep a patient alive regardless of his physical ailment or condition. This is where the clash between assuring the continuation of a normal existence throughout ageing and keeping someone on a life support machine occurs. Where do we draw the line?

The time will come, the report concludes, when the democratic legal system, heavily dependant on macro-economic forecasts will have to take all four sections of the human life equation into account. These are, firstly, the basic right of a human being to request a dignified death if necessary through notary certification. Secondly, the reduction in costs of ineffective life support systems by ‘turning off’ the machines through agreed legal parameters. The knock on effect would also reduce pension benefits to terminally ill pensioners. Thirdly is the continual research into improvement of the quality of life that will avoid the previous dramatic measures. And last, but not least, is, again through possible legislation, the recommendation of a salutary lifestyle in order to avoid the breakdown of health in the third age.

The above may sound hard to swallow but this modern and aggressive world is moving towards a system of living that will guarantee a decent lifestyle on the one hand and the legal possibility of terminating it gracefully and in dignity should the latter be unobtainable.

What steps will be taken in the future to tackle the horrific situation of the underdeveloped world and the suffering of millions of poverty stricken human beings is beyond the scope of the above analysis. Hopefully it will eventually be taken into account as a complementary aid towards a ‘quality of life for all third age human beings’.

Note: At the time of writing I have just learnt of the death of Christopher Reeves, another person who has suffered a long life of disability. Condolences to the family.
© James Skinner 2004
See also
Summer Blues
Why Terror Wins

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