16th March 2005 - Irish Examiner

We must never regard our senior citizens as a burden on resources

By Ronan Mullen

THERE is a story often told in our house about an Ireland we no longer recognise.

A poor farm labourer boasted that he was "raising a large family, paying off an old debt and putting money in the bank." How, the riddle went, could he do it?

The answer was, he was looking after his parents in his own home thereby paying off the old debt. And by bringing up a large family, he was putting money in the bank since his children would look after him in his old age.

This story recalls a time when people were more interdependent, within communities and across generations. It was not an idyllic world, of course.

We know from her now infamous autobiography that Peig Sayers was shown the door once the sister-in-law came into the house. And what seems like countless Irish plays and novels depict torrid relations between people of different generations living under the same roof.

Life today is much better. But for whom, exactly? I learned recently about a rich household where the grandmother lives with her son, daughter-in-law and their family. But the phrase 'lives with' is a misnomer. Granny resides in isolation and meals are sent up to her. She is to be seen occasionally, but not heard. Her presence is not welcome when her children are entertaining.

'Being young' has always been preferable to 'being old,' but there was a certain mutual regard. Age was honourable and youth was valuable. But as family forms change there seems to be less appreciation of what the elderly have to offer, outside of their economic and safety value as child-carers for their hard-pressed children.

And remember Charles Haughey's famous quip about Chinese leaders going on and on into old age? In the years since he made that comment, elderly people have become less prominent at the top.

Youth, or relative youth, has become a requirement for the presidency, the cabinet, business leadership - even a prime-time slot in RTÉ's programme schedule. American academics have observed that all segments of society hold negative attitudes towards ageing.

It's a point we would do well to consider in the light of the controversy over nursing home charges. Are we in danger of seeing the elderly as just a burden on resources?

Do repeated stories that acute hospital beds are being 'blocked' by older people fuel a perception that the elderly are a problem, rather than people to whom society owes an obligation and who have needs which we must address? This is not an abstract question, when you consider developments in other European societies.

In Britain, the Mental Capacity Bill currently making its way through parliament would give legal backing to 'living wills' under which people could deny themselves medical treatment in the future in the event of their becoming incapacitated. Some eminent people support this move, among them Baroness Mary Warnock, who recently suggested that the frail and elderly should consider suicide rather than become a financial burden on their families and on society.

Warnock, who has been dubbed Britain's 'philosopher queen' by the Sunday Times, has been a key shaper of British laws on sensitive ethical issues like cloning.

But it is her viewpoint on euthanasia which most clearly shows how societies without strong moral principles at their core can drift almost unnoticeably from caring to killing.

Back in 1993, Warnock sat on a House of Lords select committee which agreed a ban on euthanasia. But now she has changed her tune. She admits that a GP helped her husband, Geoffrey, to die in 1995 after he was incapacitated by a lung condition. She also says she was influenced by the case of Dianne Pretty, who suffered from motor neurone disease and unsuccessfully fought a legal battle to allow her husband to take her life.

Warnock's views are supported by Claire Rayner, the former agony aunt: "If I have brain damage because I have had a stroke not being able to express myself, or talk or write, would be just awful."

What is really awful, however, is the use of arguments about pain to make the case for euthanasia. Pain relief is part of everyday medicine and enormous strides have been made in the field of palliative care to maximise the comfort of terminally ill people.

SO called 'voluntary' euthanasia sells itself as a compassionate solution which people ought to be free to choose. But it ends up putting enormous social pressure on the elderly and infirm. Sick and disabled people are made to believe they are a burden on society or their relatives. People come to feel they owe it to their relatives and society to seek a lethal injection. After euthanasia was legalised in the US state of Oregon, the percentage of patients who thought they had become a burden to society rose as time went on. The president of the Netherlands Physicians League tells the story of a 65-year-old Dutchwoman, opposed to euthanasia for religious reasons, who was diagnosed with cancer. When euthanasia was first discussed, she refused.

But as the disease progressed she saw herself becoming a burden to her husband and asked her GP to help her die to prevent this. That's how the right to die quickly evolves into a duty.

Yet, according to Dr Nigel Sykes, medical director of St Christopher's Hospice in London, there is relatively little support among patients in Britain for euthanasia. Only 15%-20% of cancer patients want it and only 3.5% of those dying of cancer want it. Which raises the question, who really benefits from euthanasia? The dying? Or their relatives?

Baroness Warnock puts it bluntly: "I don't see what is so horrible about the motive of not wanting to be an increasing nuisance. If I went into a nursing home it would be a terrible waste of money that my family could use far better."

Her colleague in the House of Lords, former Liberal MP David Alton, puts it more nobly: "Having watched my own mother die of crippling arthritis I am not unaware of the loss of dignity and the suffering of serious illness. But I also know what would have been lost if I had commissioned her premature death or if she had been encouraged to believe that her life was worthless and that she would have been better off dead."

In Ireland we have not yet arrived at the point when eminent people are pushing for euthanasia. A certain respect for life, a sense of community and the intuition that there is more to this world than our material existence, makes such a debate unlikely any time soon.

But we are not immune to developments elsewhere. We might do well now to reflect publicly on the dignity of elderly people and the value of their lives. In that way we could pay off an old debt. And put money in the bank, too.