At the Margin of life
The inevitable fate of every human is death. Yet, its ubiquity does not make it any less of a tragedy. The ritual of funerals, annual visitations to memorial sites, and other associated behaviors affirm this sentiment. The emotional disturbances that are accompanied by death’s proximity suggest to us that it is perhaps among the most tragic of features associated with vital existence. Perhaps, the only other feature that descends lower than this is the sort of suffering that makes death a comforting notion. Irrespective of the value that we might assign to life, a reckoning needs to be made when certain extremities are placed on it. That is, one’s life is certain to have an end. If a professional has divulged to a patient that their life has reached its margin, and it is accompanied by suffering, operating from a value-based ethics of care, assisted death should be a practicable option.
Variables such as the reduction of health care costs, or expending resources and time preserving a terminally ill patient rather than utilizing resources and time to helping a patient who is not at the margin of their life seem arbitrary or impersonal. To an extent, these factors remain arbitrary under the assumption that all life is valuable. But the principle becomes less symmetrical once certain boundaries are in place. That is, there might be others who are in critical condition and the attention that is placed on our terminally ill patient might be a cause of deficiency in the attention that could be placed on the patient who is in critical condition but has a real probability of recuperating. However impersonal, these are genuine variables. It’s essential to acknowledge that the asymmetry between the two patients does not necessitate an asymmetrical value. Further, to accelerate this unavoidable fate does not necessitate a devaluing of human life—nor does mean that we should emulate the decision in a scenario that does not include life marginality.
Perhaps we might traverse a bit further down the impersonal route. It is commonly known that the world population exceeds seven billion people. An exact number for overpopulation is dubious—if possible to know—it could be manifesting presently. It appears odd to North Americans that the Chinese have implemented laws that limit a family’s child capacity in order to prevent over population, since their Capitalist principles encourage—if not stimulate—exponential population growth. Growth is an inveterate feature of the Capitalists natural order of society. Accruing growth, however, poses an inimical situation for the biosphere; its resources and capacities are, of course, incapable of maintaining a certain occupancy. This is not typically a concern for Capitalism’s interest in limitless growth. It wouldn’t be unsurprising if an extension of this principle transfers into the way we conceive of preserving life. Accepting this seemingly impersonal paradigm makes the ostensibly arbitrary costs and resources a more judicious prospect.
The transference of Capitalist’s limitless growth model onto medically induced preservation of life has made it more challenging to actually die. The seemingly arbitrary notion of pitting money against this process, again, requires rethinking. “By law, Medicare cannot reject any treatment based upon cost. It will pay $55,000 for patients with advanced breast cancer to receive the chemotherapy drug Avastin, even though it extends life only an average of a month and a half; it will pay $40,000 for a 93-year-old man with terminal cancer to get a surgically implanted defibrillator if he happens to have heart problems too” (Fisher). The implications compound, “[l]ast year, Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients’ lives” (Meyer).
What is not provided to us is an abstruse or romantic conclusion—but we aren’t even replacing a sermonic profundity with the impersonal, sardonic tone of one who has given up because their optimism has been sufficiently eradicated. Instead, there is a certain submission to our fragility. Our conception of the limitlessness of resources and growth is one that needs to be reconsidered—its implications end with a tragedy that can be avoided. Further, the transference of this system, not only in principle, but in pragmatic ways, needs to be rethought. Indeed, a reckoning needs to be made: we are not limitless. Instead, we are born into fragility, but also into a cooperative, complex system, where small decisions in input have large impacts on output and our existence is an inherent aspect of that system.