On Death

My mother, who was a dermatologist, used to regularly point out to me the illogicality of the argument "what price do you put on a human life" that is often used to attempt to justify any amount of medical intervention.

An economist would reply that the cost you would put on it would be the value to you of anything you'd have to give up to save the life - the opportunity cost. The problem is, of course, that health decisions are always of some collectivist nature - be it a Government decision of what to fund, or a private but corporate decision about what staffing levels to maintain.

The lates "health scandal" in NSW is the story of a patient who was not able to immediately be given a feeding tube iserted straight into his stomach when the tube down his throat had to be removed. The article was given the headline "starving to death".

Now this is at one level a tale that fits into the above description. The patient's daughter took the naive view of resourcing, that all resources need to be available all the time. She is reported to have said;

The system has become so appalling that people are dying simply because there is no one around to do what is needed.

But more worrying is the attitude to death revealed in the article. The paient is an 84 year old who we are told has "broken his neck". In the absence for a few days of a feeding tube the patients daughter is reported to have said;

He was just disappearing before our eyes and he was so terrified. He kept saying to me 'I don't want to die, I don't want to die'.

The first part of this is that a patient of that age, immobile in bed, getting intravenous glucose is not really likely to be "wasting away". But the truly worrying part is an 84 year old saying "I don't want to die."

We all will die.

In this particular patient's case there might be some factor I don't know about - like a soon expected first great grand child. But the fact we all have to deal with is that we will die.

There are three ways that people deal with this fact. The first is the religious way, that with death there is "hope" - of whatever the afterlife story is in that religion. The second is what I'll call the "rational atheist", in which the individual firmly believes that there is nothing after death but is fully accepting of death as a fact and that your "spirit" is the memory of what those who still live have of you (or other enduring impact).

The third, far more prevelant one, is the unthinking agnostic/atheist or uncommitted religious. This growing group has the same "fear" of death as ancient man before gods were created as a means of "explaining" life and death. They have often been shamed into their position by the likes of Peter Fitzsimons and other aggressive atheists who try to beliittle a god as an "imaginary friend" or have been successfully driven away from religion by the practitioners who deviate from my simple principles that religion needs to limit itself to "faith, hope and love".

The specific case may or may not reveal a failure in the approach to health care. But the story seems to reveal a far greater problem of a society that has become unable to accept that death is a reality that confronts us all.