Old Bird’s Eye View of the World – Mortality and the chance of a happy ending

“To be or not to be” is perhaps the most famous soliloquy about death, and – while its ruminations on whatever might lie beyond it and the linked pros and cons of suicide are from a young person’s perspective – it has some relevance to some of the big social questions facing older people in our times.

As we older people cross over the tipping point from having more than half our lives in front, to having them behind us, we come to realise that we are drawing ever nearer to the time when – for each of us, and whatever lies or doesn’t lie beyond – we will no longer be.

So, our questions start to be along the lines of how are we going to die, and do we want to have any control over that? For some, the answers are simple, and lie in life being sacred, and death being out of our control, and in a deity’s hands, and after which there is the promise of some sort of eternal after-life.

Even so, there might be preferences around end-of-life care, and choices for the immediate afterwards, regarding such options as cremation or burial, type of funeral, and dispersal of personal possessions and memorabilia. Such practical issues might, however, be only part of a more complex situation for those whose focus is on what might be sought as a good death in the here and now, rather than on prospects of some form of immortality.

In either case, as our mortal lives are visibly shortening, it becomes important to clarify our thinking about what we want, and to ensure that those who will be left behind understand and will – to the best of their ability – help us to achieve the sort of end that we wish for ourselves.

The big debate is on quality versus quantity of life. Individuals vary as to which they value most, but an individual preference for quality at the cost of quantity may not be an option within societies where we have conflicting views over how far we should be allowed to choreograph our own deaths. In one corner, there are those who fear that any such measures would lead to a slippery slope of murdering the elderly. In the other, there are those who plead that we wouldn’t let a dog endure such suffering. And currently, we have countries and states varying in whether or not to allow deliberate choices such as cessation of life-prolonging treatment, assisted dying, euthanasia, and rational suicide.

All of this is complicated by the fact that most of us do not make end-of-life choices in a vacuum. If we have people close to us, it is possible that we might feel that we don’t want to be a continuing burden to them, or – conversely – that we should hold on for longer than we’d like to for the sake of those who don’t want to lose us.

So, it is important that we clarify our thinking about what we would like, and to have conversations about this with those who are likely to be there for us in our latter days. As one resource on to how to initiate such conversations, there is a useful Conversation Starter Kit (http://theconversationproject.org/starter-kit/intro/), that is ‘dedicated to helping people talk about their wishes for end-of-life care’, and which was developed in America by The Conversation Project. It is, however, focussed on visualising types and levels of care during a terminal illness.

There is value, therefore, in extending such a conversation to cover practical issues such as what happens to the body and the possessions after death. And in not resiling from confronting the tough issues surrounding voluntary euthanasia. This, in the BBC’s Ethics site, is defined as encompassing the situation of the person who wants to die and says so, and includes cases of:

  • asking for help with dying;
  • refusing burdensome medical treatment;
  • asking for medical treatment to be stopped, or life support machines to be switched off,
  • refusing to eat;
  • simply deciding to die.

Discussions around this and other end-of-life issues can be fraught, and the introduction to the Conversation Starter Kit recognises this. As it points out, ‘having the conversation may reveal that you and your loved ones disagree. That’s okay. It’s important to simply know this, and to continue talking about it now – not during a medical crisis. [And] having the conversation isn’t just a one-time thing. It’s the first in a series of conversations over time.’

And, as is summed up in its conclusion, ‘don’t judge. A “good” death means different things to different people. Nothing is set in stone. You and your loved ones can always change your minds as circumstances shift.’ And, most importantly, ‘every attempt at the conversation is valuable.’

So, don’t put off taking the first steps. At our age, later may be too late.

Anne Ring © 2015