Human and nature

[Cinnamonmints]

I'm troubled by modern medicine taking up nature's role of natural selection without thinking of the consequences. It's like a kid deciding that they'll take care of 20 dogs out of love for them, without actually having the resources to do that. Consequently all the dogs are malnourished and unhealthy.
Naturally, a baby being born at 22 weeks would certainly die within hour(s). Now with the help of modern medicine we can save them. However there's a bigger risk of various disabilities to develop, they are sometimes behind their peers, unable to to socially integrate unless we take special measures. I am concerned about whether the lives of these babies(28 weeks and below) are ones of quality. If they're not, then it affects the lives of parents as well. If they can't properly integrate, doesn't that affect our society? It seems now, we often save lives for the sake of saving them but without thinking about the longterm consequences of the action on immediate and broader group of people. Perhaps the decision on whether to save a baby born prematurely should come from the parents, who shouldn't be stigmatized by choosing any option. But then parents would need more education. At what age should we save a baby, at what age do they still have fair possibility of having a quality life. Supposedly quality life can be achieved even with a lot of health issues, but at what cost to society which gives the conditions for that?
And on the other side, we save elderly people who, without intervention, would probably die. Once again I am concerned about the quality of their lives that society usually doesn't provide(too costly). We sometimes save people, for them to live bedbound untill definite death. For me, it feels disgraceful to treat a human like that. But how to decide when it's still possible to rehabilitate a person to an enjoyable life still and when it's no longer worth it to persist on saving them? Should we listen to the opinion of a person in question? Should we burden elderly with this, or should the relatives shoulder the difficult decision?
I'd appreciate hearing perspectives on this.

 

[Wyote]

We've put ourselves in quite a predicament by playing god.
How does one quantify the dollar amount value of a life, of certain quality levels of living.
All life is a burden upon society, the environment etc.
It's a dangerous thought game to be playing, why not execute people not pulling their weight

 

[Matty]

When disabled people aren't integrated into society, it's a reflection on the poor character of that society. Allowing society to eliminate people does nothing to improve social morals.

St Teresa of Avila wrote about the blessings that elderly and infirm nuns bring to the rest of their religious sisters. Besides the humility and patience which being cared for cultivates in the more needy nuns, the rest of the monastery learns real charity and love, through their care, respect, and service to those who cannot reciprocate.

Moral character isn't measured by how well we treat our benefactors and friends, but how we treat the weak and vulnerable.

 

[Cinnamonmints]

When disabled people aren't integrated into society, it's a reflection on the poor character of that society. Allowing society to eliminate people does nothing to improve social morals.

St Teresa of Avila wrote about the blessings that elderly and infirm nuns bring to the rest of their religious sisters. Besides the humility and patience which being cared for cultivates in the more needy nuns, the rest of the monastery learns real charity and love, through their care, respect, and service to those who cannot reciprocate.

Moral character isn't measured by how well we treat our benefactors and friends, but how we treat the weak and vulnerable.

I agree, they should be integrated. But with the modern medicine, we sort of create more disabled people than there'd normally be and more than we can manage or create a good environment for.

 

[Cinnamonmints]

It's a dangerous thought game to be playing, why not execute people not pulling their weight

Before modern medicine, nature would eliminate them and we'd have no problem with that? It's that we decided to save them. I was wondering if that's a correct way, cause sometimes their life isn't fulfilling to them or if it is fulfilling, it demands a lot of constant care from people around them.

 

[Cinnamonmints]

And I'm not saying "execute" them?

 

[Wyote]

And I'm not saying "execute" them?

My point was that it's hard to draw the line.
What defines "too disabled" or "too much of a burden"
The line becomes a tug-of-war within the minds of everyone and creates a battleground/pendulum.
It could swing that far, or it could swing the other way where we try to save every living thing to our own detriment/demise.
As it stands now, we try to find a middle ground which I think is the reasonable option.
It's always swaying a bit though.

 

[Cinnamonmints]

My point was that it's hard to draw the line.
What defines "too disabled" or "too much of a burden"
The line becomes a tug-of-war within the minds of everyone and creates a battleground/pendulum.

Okay, makes sense.

It could swing that far, or it could swing the other way where we try to save every living thing to our own detriment/demise.
As it stands now, we try to find a middle ground which I think is the reasonable option.

And exactly! Although, how are we finding middle ground if medicine is always pushing towards saving more people? What's pushing the other direction?

 

[Wyote]

What's pushing the other direction?

You, for one.
There are efficiency/cost cutting measures implemented all the time.
Decisions are made regularly that essentially either directly or indirectly cost thousands of people their lives.
Just because an ability/tech/fund exists, doesn't mean it's being allocated or used properly.
We don't like talking about that though.
Which I think is what you are driving at here.
How do we even know when we've arrived at a proper place of usage?
Again, it's kind of a tug-o-war that never ends. People have different opinions.
As long as we are engaging in the conversation and adjusting/refining then we have a good system.

I agree largely with @Matty 's sentiments.

 

[Cinnamonmints]

You, for one.
There are efficiency/cost cutting measures implemented all the time.
Decisions are made regularly that essentially either directly or indirectly cost thousands of people their lives.
Just because an ability/tech/fund exists, doesn't mean it's being allocated or used properly.
We don't like talking about that though.
Which I think is what you are driving at here.
How do we even know when we've arrived at a proper place of usage?
Again, it's kind of a tug-o-war that never ends. People have different opinions.
As long as we are engaging in the conversation and adjusting/refining then we have a good system.

I agree largely with @Matty 's sentiments.

I see. So you'd prioritize saving the lives over bettering the quality of life for others? Or am I misunderstanding?
I'd say we would arrive at a proper place of usage if people are fulfilled and content about their lives. Then we can expand to saving more lives and taking care of the weak.
And thank you for summarizing my views nicely.

 

[Wyote]

I see. So you'd prioritize saving the lives over bettering the quality of life for others? Or am I misunderstanding?
I'd say we would arrive at a proper place of usage if people are fulfilled and content about their lives. Then we can expand to saving more lives and taking care of the weak.
And thank you for summarizing my views nicely.

I'm saying I prioritize continued discussion about it.
As it stands, I think things are ok but can be improved upon.

 

[dragulagu]

I see. So you'd prioritize saving the lives over bettering the quality of life for others? Or am I misunderstanding?
I'd say we would arrive at a proper place of usage if people are fulfilled and content about their lives. Then we can expand to saving more lives and taking care of the weak.
And thank you for summarizing my views nicely.

You are mixing up perspectives here. He isn't taking up a personal one in the question, rather explaining the current course.

 

[aeon]

As for newborns, I suppose we just aren’t willing any longer to abandon the unfit on the hillside, left to the wolves. Personally, I could defend either position, although I would err to the side of saving, because who knows how a flower may bloom.

EOL approach must always ask to what end, what cost, what support will be required, what are likely outcomes, and what are best practices. I have my DNR in order such that I am explicit about what I would like done (not much) and what is forbidden in the event of a threat to life. All my organs, tissues, and ortho are spoken for when I shuffle off this mortal coil.

Spending fat stacks to keep someone nominally alive is a fool’s errand, but people will do as they will.

I already know what bedbound is. There’s nothing to recommend it beyond the bomb dope they might give you. Fentanyl and an IV benzo might allow you to leave the bed for a time.

Cheers,
Ian

 

[John K]

I'd appreciate hearing perspectives on this.

I think this quote from Tolkien gives a clue

It can be applied to omission as well as to the active taking of life. Which of us can put a value on someone else's life? One of the most prominent physicists of our era was severely handicapped yet lived on for decades beyond all expectation and became a household name - not for his disability but for his genius. We each only get one shot at life, and it comes and goes in a flash compared with the age of the universe. It's luck and privilege beyond all counting to be alive - for each one of us, there are an uncountable numbers of others that could have lived instead of us but were passed over by the fates. These are the children that our parents could have conceived instead of us, and those our grandparents didn't have and so on back to the dawn of time. We are so familiar with our everyday lives that we take each other for granted, but when you look at our world from remote outer space, and consider each of our lives, it is one of the most precious things in the Universe, and so are each of us, no matter what our state or condition. Every one of us is precious beyond measuring, each of us a separate world that we bring to life that wouldn't exist without us. I think that we have a collective obligation to give each person as much a chance of life as we can.

Now of course resources are limited, and it isn't possible to solve every problem - but that's not the same as withholding support that could be given. The former is simply the way the world is - we do the best we can with what is available; the latter is to play god without the wisdom to do it.

The issue isn't simply black and white and there are times when I do think it can be right to withhold what may keep someone alive.



My father was in late stage dementia and 99 years old. He had been fading for weeks and was not expected to live more than a few hours or days. His GP agreed with us that there would be no point in resuscitating him when the time came and he died peacefully in his bed in his care home. He would not have been conscious if they had brought him back - it would only have kept him going a few hours longer, and I think this was right. Two years earlier though I'd have insisted they tried to bring him back. He had three good years in the care home even though he was unable to care for himself and was confused a lot of the time - even so, he was laughing and joking with the care staff who loved him, and could still beat us hands down at rummy.

I don't regret any of the demands my father's condition placed on me. I didn't have to physically care for him to a great extent, but I had the responsibility of seeing him safely through his 6 years of illness and sorting out his life, his house, his care, his safety. It was very demanding emotionally, and in commitment of my time, but I don't regret any of it - it's in things like this we learn what it really means to love someone, as @Matty is saying. I think it's never right to withhold the possibility of life until life is irrevocably gone anyway.

 

[Cinnamonmints]

I'm saying I prioritize continued discussion about it.
As it stands, I think things are ok but can be improved upon.

I see, sorry.

 

[Cinnamonmints]

I think this quote from Tolkien gives a clue

It can be applied to omission as well as to the active taking of life. Which of us can put a value on someone else's life? One of the most prominent physicists of our era was severely handicapped yet lived on for decades beyond all expectation and became a household name - not for his disability but for his genius. We each only get one shot at life, and it comes and goes in a flash compared with the age of the universe. It's luck and privilege beyond all counting to be alive - for each one of us, there are an uncountable numbers of others that could have lived instead of us but were passed over by the fates. These are the children that our parents could have conceived instead of us, and those our grandparents didn't have and so on back to the dawn of time. We are so familiar with our everyday lives that we take each other for granted, but when you look at our world from remote outer space, and consider each of our lives, it is one of the most precious things in the Universe, and so are each of us, no matter what our state or condition. Every one of us is precious beyond measuring, each of us a separate world that we bring to life that wouldn't exist without us. I think that we have a collective obligation to give each person as much a chance of life as we can.

Now of course resources are limited, and it isn't possible to solve every problem - but that's not the same as withholding support that could be given. The former is simply the way the world is - we do the best we can with what is available; the latter is to play god without the wisdom to do it.

The issue isn't simply black and white and there are times when I do think it can be right to withhold what may keep someone alive.

View attachment 91253

My father was in late stage dementia and 99 years old. He had been fading for weeks and was not expected to live more than a few hours or days. His GP agreed with us that there would be no point in resuscitating him when the time came and he died peacefully in his bed in his care home. He would not have been conscious if they had brought him back - it would only have kept him going a few hours longer, and I think this was right. Two years earlier though I'd have insisted they tried to bring him back. He had three good years in the care home even though he was unable to care for himself and was confused a lot of the time - even so, he was laughing and joking with the care staff who loved him, and could still beat us hands down at rummy.

I don't regret any of the demands my father's condition placed on me. I didn't have to physically care for him to a great extent, but I had the responsibility of seeing him safely through his 6 years of illness and sorting out his life, his house, his care, his safety. It was very demanding emotionally, and in commitment of my time, but I don't regret any of it - it's in things like this we learn what it really means to love someone, as @Matty is saying. I think it's never right to withhold the possibility of life until life is irrevocably gone anyway.

Thank you for your answer. I'm not speaking about people who acquire the disability in their lifetime, we should always try our best to save and rehabilitate them. Goes to show that even healthy babies can acquire disabilities in their lifetime. The cases I am worried about is when we save very premature babies, who have a very high risk of a disability that will lead them throughout their life. It's almost determined that they'll have a disadvantage. And the case you presented, when life is no longer life. It seems very difficult to judge correctly at these moments. What if a person is conscious at least to a degree, but they're bedbound and they can't do anything but maybe watch tv, which is a thing at a care home.

 

[Cinnamonmints]

because who knows how a flower may bloom.

true, but comparing very preterm babies to fullterm, 30% of them are behind in school, compared to 5% fullterm and 1,8% are gifted, compared to 9% fullterm. It's only academic performance, so it's difficult to judge, but it's a bit worrying.

 

[Wyote]

I see, sorry.

No need to apologize.
You are asking about some specific topics with babies/elderly etc. and I took it to macro levels.
I think your concerns are valid.

 

[John K]

Thank you for your answer. I'm not speaking about people who acquire the disability in their lifetime, we should always try our best to save and rehabilitate them. Goes to show that even healthy babies can acquire disabilities in their lifetime. The cases I am worried about is when we save very premature babies, who have a very high risk of a disability that will lead them throughout their life. It's almost determined that they'll have a disadvantage. And the case you presented, when life is no longer life. It seems very difficult to judge correctly at these moments. What if a person is conscious at least to a degree, but they're bedbound and they can't do anything but maybe watch tv, which is a thing at a care home.

I agree - this is a dilemma isn't it? The problem arises when there is no escaping the need for a judgement, but when the individual affected is incapable of making the judgement for themselves. One of the hardest judgements I had to make was not one of life and death, but when I had to stop my dad from driving at the age of 95, and he lost his independence. He would never have stopped himself, and he would have gone on until he had a serious accident - I probably left it longer than I should have, and it left me pretty shaken because it was so life changing for him. The judgement in these situations cannot be avoided though, because doing nothing is as much a judgement as doing something. All we can do is act in as much good faith as we can if we have to do this sort of thing for another.

The dilemma with very premature babies will eventually go away I suspect, because technological and medical advances will mean we will be able to gestate safely to full term from conception outside the womb. That may well bring other problems to the table of course.

A problem that has occurred to me in the past, really extrapolating from yours, is whether we are making our gene pool very unstable by preserving to adulthood those people who would otherwise have died before having children. Is it possible that in the future, the average human being will be far less healthy than at present because of this? I have no answer to this one - I just hope that it's an unwarranted fear. It may well be unwarranted because natural selection works on regardless - at present it is selecting for those of us best fitted to our modern societies.

 

[Cinnamonmints]

I agree - this is a dilemma isn't it? The problem arises when there is no escaping the need for a judgement, but when the individual affected is incapable of making the judgement for themselves. One of the hardest judgements I had to make was not one of life and death, but when I had to stop my dad from driving at the age of 95, and he lost his independence. He would never have stopped himself, and he would have gone on until he had a serious accident - I probably left it longer than I should have, and it left me pretty shaken because it was so life changing for him. The judgement in these situations cannot be avoided though, because doing nothing is as much a judgement as doing something. All we can do is act in as much good faith as we can if we have to do this sort of thing for another.

Yeah. And you're right. That sounds difficult. Your dad lived a healthy life then tho, cause by the way you describe he seemed to have been very functional to almost very end. And thank you for sharing this

The dilemma with very premature babies will eventually go away I suspect, because technological and medical advances will mean we will be able to gestate safely to full term from conception outside the womb. That may well bring other problems to the table of course.

That was exactly what my dad said when I brought this up to ask him. That's true. What would the other problems be?

A problem that has occurred to me in the past, really extrapolating from yours, is whether we are making our gene pool very unstable by preserving to adulthood those people who would otherwise have died before having children. Is it possible that in the future, the average human being will be far less healthy than at present because of this? I have no answer to this one - I just hope that it's an unwarranted fear. It may well be unwarranted because natural selection works on regardless - at present it is selecting for those of us best fitted to our modern societies.

I think it's possible. Maybe if gene modification was a success tho it'd solve it, but to take a genome into our hands is an uncomfortable idea. And would the picture of "best fitted for modern society" change? Because 'the weak' and 'the strong' don't use the same strategies? There should be some differences