What Is Natural Death?

Most of us have a good idea of what we mean by "natural death," yet the term has become somewhat difficult to define. According to pathologists, "A natural death is a death that results from a natural disease process, distinct from a death that results from accident or violence." But nowadays death from disease is rarely allowed to be natural; it is artificially prolonged by drugs and/or machines and in the eyes not only of medical professionals but of most patients and families, it results from medical measures' failure. It can hardly be said that someone who has spent his or her last hours in an ICU, as pictured on the page about death at www.stewardsoftheflame.com, has died naturally.

The fundamental premise of Stewards of the Flame is that the the logical culmination of this trend would be to deny death entirely, assuming that the machines were "improved" to the point of keeping mindless bodies functioning indefinitely -- and that this would be a very bad thing. Natural death, in my opinion, is death resulting from the normal shutting down of the body when the unconscious mind is ready to die. It happens to everyone, if no accident or acute disease strikes prematurely, as long as the process is not thwarted by interference with the body in the way all too common today. I am aware that this view is termed "deathism" by the proponents of technological life extension, some of whom fervently believe that physical immortality is just around the corner. I don't think it's going to turn out that way. I think people will go on dying in old age (older than the present maximum) no matter what technology does to repair their bodies.

The life-extension enthusiasts admit that people might get bored in time and say that in that case, they could kill themselves. I have personally known people who say this. And of course, the issue of assisted suicide for the terminally ill is a major controversy today. I live in Oregon, where assisted suicide is legal, so I hear a good deal about it. I fear that if such a choice is legitimatized and becomes common, some people will choose to hasten death merely to spare their families the physical and financial burden of caring for them, and eventually those of us without families may be subtly discouraged from continuing to receive care at the expense of the taxpayers. This situation would not exist if high-tech intervention were not automatically employed early in the course of illness which, in the case of an elderly person, is inevitably going to be fatal.

There has been a lot of discussion in the past few decades about the pointless and often cruel way in which people are routinely treated in their last months of life, and many calls for reform. But though the solution -- hospice care -- is now available, comparatively few people take advantage of it. Many are simply unaware that it exists. Others, or their families, are so conditioned by our culture's denial of death that they believe rejecting futile treatment is tantamount to suicide, or at best an abandonment of "hope." In my novel, the forced prolongation of pseudo-life is not arbitrarily imposed by the medical authorities that run the planet; it is a law supported by the people, who do not want to admit that they are mortal. I suspect this is a realistic assumption about what would happen. The vast majority of Americans polled say that they want to die at home, not in a hospital; yet they end up in hospitals all the same. Continuation of treatment is not compulsory, yet most don't contest the medical establishment's imposition of it, perhaps because don't know that they can -- that there are better alternatives -- or perhaps because society as a whole offers no support for the idea that the natural ending of life need not involve suffering. Unfortunately, the only thing likely to bring about widespread change is the financial impossibility of providing high-tech terminal care to an aging population.