Friday, October 19, 2007

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.

13 comments:

Panzermeister said...

Spare parts or complete new body?

shitney said...

Hi,
I know this is from months ago, but I just found your post through a google search for "natural death." I arrived at this search after several completely unsuccessful, related search terms, all made out of my curiosity about others who share my all-too-unconventional belief that immortality is unnaturally regarded as the new standard for medical and technological achievement. It seems mind-boggling to me that people can regard death as something to be put off indefinitely through the assistance of medicine, yet at the same time I question how I will be able to reconcile my belief that medicine is an unnatural way to keep living with my own urge to survive when the time comes to make such potentially life-prolonging decisions. I was just wondering if such fears plague you, and/or how you have resolved to deal with them?

Sylvia said...

Thanks for your thoughtful post. I think your question arises because you are young. Of course you wouldn't want to die prematurely. But if death is not something to be put off indefinitely, if it is a natural phase of existence, then people reach a stage when they have no desire to put it off. As I say in my novel, "Underneath, they seek something more than can be attained in life, something beyond, without which the struggle of living would have no meaning. Not necessarily the sort of afterlife depicted by religious metaphors. A person doesn’t have to believe consciously in any form of continued existence.... But there’s a built-in human longing for a state of being we can’t put a name to, a yearning that extra years can’t satisfy. Eventually, everyone comes to a point where there’s nothing more to be gained from living, even if the awareness of that fact is buried deep inside.”

This is said in reference to people in their late 90s who have been healthy until then. I'm in my 70s, and I am by no means ready to die yet. There's still a lot I want to do with my life. But I'm old enough to imagine feeling that way later on.

To be sure, people not yet ready to die from old age often have medical conditions that require decisions about life support. And we do want to improve medical technology to cure as many such conditions as possible. But people who truly have no chance of survival do not, I think, want to prolong the dying process to the point of being only half alive. Their unconscious minds know whether or not it's time to go. It's the observers who can't admit that there is such a time, because their own urge to survive is still strong and they project it onto those who are already past that point.

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A natural death is a death that results from a natural disease process, distinct from a death that results from accident or violence.

teeter hang ups said...

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

teething symptoms said...

normal death is what God condemned us from the very beginning, we are condemned to live forever knowing that for longer than we make life at one time or another we will have to die!

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Alan's little sister said...

My brother, aged 65, was diagnosed with terminal cancer in his pancreas, lungs, colon, liver, kidneys. He had only weeks to prepare for his death. He did not want to be hooked up to machines and die a slow death in a hospital somewhere. He set his things in order, and tried to live as normal a life as he could, until in the last 2 weeks he was pretty much bedridden. A hospice nurse came to his home regulary, and the day before he died, he was admitted to the hospice facility itself. He was restless, and he died the next day. He only took medicine for the pain, and oxygen. That's it. He died this past Tuesday, and I am so proud of how he lived his life, and how he allowed his own death to happen without all the artificial life support that hospitals like to dole out. I plan, when my time comes, of following his example. If it were legal, I would prefer myself to be euthanised when the pain becomes too great. I think we are allowed to show mercy to our suffering pets, but not when it comes to ourselves or our family. That is a shame. A tragic shame.

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