Thursday, April 26, 2007

Buying Death

I am writing a paper for my "Death and Dying" honors seminar that is turning out to be far more massive than I had anticipated. I eventually want to argue that a paradigm change in governance is the only debate relevant to policy regarding death and dying. I hope to make clear that, like hot button political topics such as the abortion debate, there needn't be discussion of private matters in the public sphere. With respect to the public debate surround death and dying, these talks of "individual autonomy" (choosing to pull your life-cord if you feel bad about depleting your family's savings on you and your [for example] half-dead brain in the event that your body is entering its dying process) is essentially bullshit because some people do, and ought to, rely heavily on a traditional upbringing (and some even critique this system which they love) that might clash or even precisely oppose our hegemonic American pseudo-Christian Materialistic culture. Policy should instead leave the philosophizing to the utterly capable individual and take care of our material lives with a more balanced distribution of wealth, resources, and services. No/yes-to-abortion? Can we please reframe and instead worry about taking care of the families and individuals in dire need of basic necessities and protection (I would argue the abortion debate is a class issue more than anything else). Furthermore, let people choose to do whatever they'd feel comfortable with within their own social milieu when it comes to dying (and maybe when we come up with a way to help the government gets it's act together, people may get a chance to die peacefully rather than wanting to die without having to burden their families. This term we have 'death with dignity' cloaks a crucial aspect to death which is monetary). And with respect to our hegemonic milieu in United States, let's do the best we can to overcome the egoism.


Viva La Revolucion!

Here's a draft:

Introducing the Snobby Death

As the film Wit demonstrates, there exists strong tension between uncompromising academic standards and common or ordinary thought. I will explicate these two concepts later. The protagonist, Dr. Vivian Bearing (Emma Thompson) is a professor of literature who undergoes treatment for her ovarian cancer. Dr. Posner (Jonathan M. Woodward), who is a recent graduate, takes on the project of studying the effects of a new treatment using Prof. Bearing’s body for his case study. Her cancer progresses to a terminal stage at which point Dr. Bearing must choose one of two options. She may express desires to stop the treatment and let the cancer take its own route in her body. Or, she may choose to continue undergoing severely painful treatment, with no hope of total recovery, and with the potential of dying a miserable death from this treatment, rather than effects of the cancer itself—in order to contribute to the field of medical science (and the selfish Dr. Posner’s celebrity status in his field).
The dichotomy is set up here is between the pursuit of knowledge in academia and the individual ordinary person. The academic standard is a relatively easy concept to grasp as highlighted in my rough sketch that follows. Since the 18th Century Enlightenment movement in Europe and America, which emphasizes reason, science, and rationality and from which the structure of the modern university, with its separate and evermore specialized academic disciplines springs; the academic standard can be understood as the governing principle keeping consistent the contribution of knowledge with respect to each discipline, for and of the society at large (“Academia” Wikipedia).

Since Wit focuses on the case of a medical researcher, albeit a pompous one—academic standards with respect to medical research specifically can be understood as a rigorous persistence to the contribution of knowledge that explores how people may best benefit from treatments with the least amount of side effects and cost, meeting legal standards, and without specific commercial goals. However, ordinary thought, and not academic thought, I argue, is the far more complicated half of the academic versus ordinary dichotomy with respect to death and dying.

Bioethics is the logical extension of medical research with respect to meeting legal standards after any given treatment has been developed and is ready for distribution or practice. The law and bioethics are both professional levels with their roots in the modern university—both with reason, rationality, and the scientific method, due to the 18th century Enlightenment movement, at the very core and circulating throughout. Thus, the endlessly controversial death question that Wildes brings up has at its core the tension between the varying definitions of death and each definition’s requisite codes of behavior versus standardizing the deployment of medical resources.

The poet and philosopher, are they better at dying?

According to Barry, “ordinary thinking is ordinary precisely because it is customary, established, popular, and conventional. There is nothing distinctively individual about it. It’s basically “group think” (Barry 5). Barry makes an interesting claim because the adjectives he uses to describe thinking may as well be applied to defining tradition. What Barry is attempting to do here is frame his argument, which is that a philosophical (a term I will grapple with at length later) approach is in accordance with dying a good death. He distinguished a passive acceptance of death and indubitably life, with respect to the individual’s milieu, from a higher level of cognition and the individual’s personal dedication to colossal questions about the human condition, and suggests that the latter is preferable.

However, this higher level of thought that Barry is referring to is, I argue, another example of tradition sui generis. T. S. Eliot, in his essay “Tradition and the Individual Talent,” asserts that “every nation, every race, has not only its own creative, but its own critical turn of mind; and is even more oblivious of the shortcomings and limitations of its critical habits than of those of its creative genius.” Eliot describes the appropriate use of tradition by the individual as a fierce dedication to accumulating knowledge of one’s predecessors in order to then find his or her poetic voice before inserting it back into the poetic tradition. For Eliot, tradition is omnipresent. If a poet attempts to write unconscious of the tradition that he or she is essentially participating in, the resulting work will be unsuccessful because pre-established traditions will clumsily slip into the work on their own before having passed through the poet’s creative apparatus. Eliot here is talking about a tradition of higher levels of thought, thus Barry’s claim is erogenous because he wrongfully assumes that higher levels of thought, such as philosophy or poetry, is a separate space from tradition when in fact, creating new philosophy depends highly upon a tradition of philosophers because the philosophic mind is in conversation with its predecessors before placing itself in a unique position in relation to the predecessors. Thus, the philosophy Barry argues for is in part another tradition or custom of the discipline of philosophy.

As Eliot describes “We cannot refer to "the tradition" or to "a tradition. ...Seldom, perhaps, does the word appear except in a phrase of censure” (Eliot). According to Eliot, we tend to suppress the idea of tradition and instead, encourage the individual mind, as Barry does. He masks the concept of tradition with the words, ordinary, popular, conventional as a rhetorical devise in order to stigmatize tradition.

Despite of the linguistic clash, as Barry denies tradition and views the “customary” in a negative sense whereas Eliot fervently champions tradition, Barry and Eliot essentially take the same position. Let’s consider Eliot’s concept of the traditional poet and Barry’s philosopher as synonymous as I have demonstrated. Eliot describes the traditional poet as one who can converge the old with the new, thus altering the entire discipline of art with the addition of his work since all who follow him must take into consideration his or her point of view, including his of her influences (the entire catalogue of great poets), before a new poet adds to the tradition, and so on, forever.

The poet must be very conscious of the main current, which does not at all flow invariably through the most distinguished reputations. He must be quite aware of the obvious fact that art never improves, but that the material of art is never quite the same. He must be aware that the mind of Europe—the mind of his own country—a mind which he learns in time to be much more important than his own private mind—is a mind which changes, and that this change is a development which abandons nothing en route, which does not superannuate either Shakespeare, or Homer, or the rock drawing of the Magdalenian draughtsmen. (Eliot)

Barry uses a derogatory sense of a culturally specific or group thought. Thus, Eliot’s position with respect to the definition of a ‘group’ or the “mind of his country” appears at first glance to be in direct contradiction with Barry since Eliot facilitates this concept in a positive light. One could mistakenly argue that, unlike Barry, Eliot champions tradition since he functions within his academic milieu or culture if you will, of poetic genius and in effect depends upon and celebrates his predecessors. However, Eliot and Barry are precisely in line with regard to the way in which the individual ought to approach one’s mortality, or that one should face it at all.

The poet in Eliot’s sense and Barry’s philosopher are synonymous. “It [tradition] cannot be inherited, and if you want it you must obtain it by great labour” (Eliot). Barry too argues for a specialization of thought, a laborious approach, and a philosophical posture in order to rightly comprehend the cultural “convention” (Bary 5), or “the mind of his own county” (Eliot) in order to reflect most meaningfully on his or her own fleeting mortality. This is in line with Eliot’s insistence that the successful poet should be “of the timeless and of the temporal together.”

What is important here is that both are essentially agreeing that the individual ought to dedicate oneself to the pursuit of existential questions with respect to the individual’s respective milieu or “country.” Eliot’s extension of Barry’s notion adds that this pursuit must be with and through the filter of one’s respective milieu, which is inextricably bound to one’s creativity. The conclusion both authors have is that this dedication to a higher level thought or endless process of personal enlightenment throughout one’s life then grants the individual a better career, for Eliot, and a better death, for Barry.

A Dangerous Philosophy

I will now explain the problematic concept of Barry’s philosophy before I later problemetize the concept of philosophy as the preferable approach to death and dying on behalf of the individual. Barry takes on the task of defending philosophy over ordinary or the passive acceptance of traditional thought, sans critical contemplation. Barry’s philosophy does not account for Eliot’s construction of tradition. For Eliot it is necessary to fuse tradition with the individual voice, and the location of this fusion takes place within the individual creative mind; as I have already argued that these two authors take the same position with respect to how one should approach his own mortality—with Eliot’s point as a redeeming appendage to Barry’s problematic logic.
Ordinary thinking also tends to be naïve, uncritical, and unquestioning, even gullible. Philosophical thinking, by contrast, is sophisticated in the sense of being skeptical and searching. Reasoning—the process of following relationships from thought to thought so some ultimate conclusion—is crucial to philosophical thinking, peripheral to ordinary thinking. Philosophical thinking engages the fundamental questions to human existence in a disciplined, imaginative way; ordinary thinking does not” (Barry 5).

We can begin to see that Barry, like Eliot, is taking a position against the passive acceptance of tradition which conversely will lead to poetic success, for Eliot, or an “imaginative” (Barry 5) approach when contemplating death. However, there is a departure from Eliot’s concept of a poet with Barry’s approach to the “imaginative” death, or the philosopher.
By contrast, the knowledge with understanding that philosophical thinking aims for ideally separates the individual from the herd by moving one in the direction of rational autonomy. “Rational autonomy” basically refers to the freedom of being able to decide for oneself by using one’s own mind. Rational autonomy means living one’s own life, something that suddenly is of utmost importance to Ivan Ilyich. (Barry 5)
Barry is saying here that “one’s own mind” is a separate entity from tradition. For Barry, the pursuit of philosophical knowledge requires throwing off the chains of tradition. Barry implies that philosophy comes from within as some sort of decision or set of decisions that one carries with them through life. It is as if philosophy, for Barry, is a physical space in the brain or appendage on the body and, like a muscle, it must be exercised of the goal is developing strength.

Clearly Barry’s philosophy is an erroneous construction because, as Eliot points out, the mind functions within a tradition when setting a goal for itself. With this in mind, let’s consider Barry’s argument that contemplation leads to a good death with his example of Leo Tolstoy’s The Death of Ivan Ilyich.

And every moment he felt that despite all his efforts he was drawing nearer and nearer to what terrified him. He felt that his agony was due to his being thrust into that black hole and still more to his not being able to get right into it. He was hindered from getting into it by his conviction that his life had been a good one. That very justification of his life held him fast and prevented his moving forward, and it caused him most torment of all. (Tolstoy)

This passage from The Death of Ivan Ilyich illuminates Barry’s position which is that a confrontation with death will prevent such a tormenting final moment of mortality that Tolstoy creates through the fictional character Ivan Ilyich. Let us now compare Tolstoy’s Ilyich with another troubled 19th Russian philosopher and novelist, Fyodor Dostoevsky and his foray in the literary grapple with mortality through his unnamed character in the philosophical novel Notes From Underground. Dostoevsky’s underground man writes notes or journals of his life and thoughts, all of which are collected by an unnamed fictional publisher who frames the story.

Unlike The Death of Ivan Ilyich, Notes From Underground is primarily narrated from the first person: the underground man himself. This is an appropriate literary choice on behalf of Dostoevsky because it emphasizes the point that the underground man is a highly philosophical figure. Giving the narrative voice to the character buttresses the point that the underground man is “living his own life” as Barry saids and not living vicariously through an omnipresent author, like Ilyich. The underground man is hyper-aware and thus hyper-opinionated with respect to his mortality. His self-awareness is the primary engine in his life, which is only punctuated by his futile attempts to become a social being. Each attempt leads only to horrible embarrassment, encouraging the underground man’s envelopment in his own despicable construction of the world, thus making him an absolutely detestable, even grotesque character for the reader.

“…..I don't know, to this day I cannot decide, and at the time, of course, I was still less able to understand what I was feeling than now” (Dostoevsky). The underground man returns again and again to past thoughts. He desperately searches for some logical relationship between his immediate situation and his past, in a futile attempt to suspend his confusing and terrible life in some refined logical structure. “I cannot get on without domineering and tyrannising over someone, but ... there is no explaining anything by reasoning and so it is useless to reason (Dostoevsky).”

The underground man’s posture of hyper-contemplation and desperation for a beautiful order to his life leads him to denounce reason because he cannot escape his central problem: getting insulted by other points of views. This negative response to conflicting perceptions has conditioned the underground man to respond with spiteful imposition of his perspective onto other people, as if this response was a natural reflex. He of course is unsuccessful and his attempts to squash other points of view lead to his experiences of total humiliation each time he interacts with another person. He even looses hope of being saved by a romantic relationship with Liza, the whore he almost falls in love with, because he inappropriately condescends to her and she subsequently leaves him. His fate is piteous isolation and self-destruction and we are left with only a severe distaste for this character.

Yes--you must answer for it all because you turned up like this, because I am a blackguard, because I am the nastiest, stupidest, absurdist and most envious of all the worms on earth, who are not a bit better than I am, but, the devil knows why, are never put to confusion; while I shall always be insulted by every louse, that is my doom! (Dostoevsky)

In comparison to the underground man, Ilyich should perhaps be thankful that Tolstoy denied him of self-awareness and philosophic considerations of his mortality. However, the point here is that the reflection on one’s mortality is not an objective or universal answer to avoid dying in regret and sadness, as can be understood with these two extreme examples in literature. Returning to Barry, “A lifetime of philosophical thinking well prepared the gadfly of Athens for death; a lifetime of ordinary thinking left Ivan Ilyich pitifully unprepared” (5). Barry’s comparison is clearly limited and, as I will argue, his championing of a philosophical approach to death and dying is dangerous.

The “Ordinary” Death

As I have suggested earlier, the term ordinary is complex. Barry’s problematic interpretation qualifies ordinary thinking as a tendency “to be naïve, uncritical, and unquestioning, even gullible" (Barry 5). He then asserts that the non-gullible mind, i. e. the philosopher, will attain “knowledge with understanding that philosophical thinking aims for [which in effect] ideally separates the individual from the herd by moving one in the direction of rational autonomy” (5). What Barry dangerously suggests here is that the philosophical route as opposed to the customary or traditional route is not only most successful way to grapple with death (and as I’ve already demonstrated with Eliot’s article—philosophy fiercely depends upon its own customs when generating new philosophy), philosophical thinking is the way that will lead the individual to conforming with the position that “rational autonomy” as a way to standardize death on the broad political and bioethical level is the best answer. This claim is obviously erogenous because we know that the death topic is perpetually controversial, as Wildes points out. If “rational autonomy” was the only answer, then the scorching hot death debate would be a little cooler or even non-existent.

Returning to Barry’s herd metaphor is interesting when in comparison with Miran Epstein’s article, in which Epstein argues that “economic pressures have been part of the historical circumstances that have determined which kind of end-of-life ethics contemporary society has been likely to endorse.” Barry’s herd metaphor that philosophical thinking “separates the individual from the herd by moving one in the direction of rational autonomy” implies that the better sheep will agree with one concept over another, and continue to be as blind as “the history of contemporary end-of-life ethics” (Epstein) when it comes to the political economy of death.

Epstein uses a herd metaphor in an illuminating way. He claims that “most people have little problem with the economics of life and death insofar as the handling of livestock is concerned, they would deem the application of this rationale to humans as utterly immoral” (Epstein). In Epstein’s article, he demonstrates that “autonomy” is a cover-up for the fact that “economic factors do creep into the ethically legitimate decision-making of the individuals and governments as regards to end-of-life decision making” (Epstein). The principles of a good death, as listed in BMJ include retaining “control of what happens,” being able to “leave when it is time to go, and not to have life prolonged pointlessly” (Smith). In addition to these conditions, Epstein lists some reasons for why people have requested physician-assisted suicide—“fear of becoming a burden on others and fear of loss of independence and control over one’s life” and as Epstein points out, any of these interpretations of the preferable death or why one chooses death might very well reflect economic pressures as they relate to a “duty to die,” but the economic factors are never voiced since “official moral codes reject the existence of such a duty [choosing death to spare loved ones’ money]’ (Epstein).

Since the political economy of life and death is suppressed but still relevant to personal decisions about death, we are in a sense a herd, following the definitions and policies that precede our own constructions of death. Returning my argument that the Barry/Eliot definition of creativity is never separate from the individual mind and requires intense dedication when creating a new philosophy or poem; the definitions of death circling through bioethics and law can be added to the tradition from which individual creativity springs. The danger with this is that, as Epstein argues, we become passive receptors of the underlying political economy that influences political decisions when standardizing death. We have returned to the ordinary process of thought, which according to Barry, means that one refuses to think critically or simply ignore a painful or complex issue such as death. However, as Epstein points out, how are we to be “skeptical and searching” (Barry 5), when that which demands the most verbal scrutiny is stigmatized? My point here is not to make any claims about the character of society or that there is any covert effort on behalf of the government to suppress our opinions. I instead hope to point out that much of the debate surround issues regarding death and dying are essentially a language war. I am attempting to organize the major points of the debate in order to redirect the language to the unmarked yet crucial space of political economy.

Philosophical Pluralism

Let us now consider how the philosophical approach is not only not better but even dangerous in a pluralistic society. Returning to the underground man versus Ivan Ilyich, the underground man suffers because he is aware of his own tyrannical subjugation of others.

Even in my underground dreams I did not imagine love except as a struggle. I began it always with hatred and ended it with moral subjugation, and afterwards I never knew what to do with the subjugated object. And what is there to wonder at in that, since I had succeeded in so corrupting myself, since I was so out of touch with "real life," as to have actually thought of reproaching her, and putting her to shame for having come to me to hear "fine sentiments"; and did not even guess that she had come not to hear fine sentiments, but to love me, because to a woman all reformation, all salvation from any sort of ruin, and all moral renewal is included in love and can only show itself in that form (Dostoevsky).

Again, his demise is the lack of sensitivity for other perspectives. The underground man is a tyrant and irrevocably corrupted.
Returning to Ilyich’s redemption after having lived his life with a passive posture with respect to his own mortality: “And death...where is it? He sought his former accustomed fear of death and did not find it. "Where is it? What death?" There was no fear because there was no death. In place of death there was light ” (Tolstoy). The omnipresent unidentified narrator has redeemed Ilyich, despite of Ilyich’s weak philosophical apparatus. When comparing Ilyich’s sudden redemption with the book of revelations, a clear relationship can be drawn.

There shall no longer exist there anything that is accursed (detestable, foul, offensive, impure, hateful, or horrible). But the throne of God and of the Lamb shall be in it, and His servants shall worship Him [pay divine honors to Him and do Him holy service]

This passage informs Ilyich’s condition because an older Tolstoy, having written this novel near the end of his life, he himself was a philosopher who struggled with his own mortality and eventually converted to Christianity just before he died.

And there shall be no more night; they have no need for lamplight or sunlight, for the Lord God will illuminate them and be their light, and they shall reign [as kings] forever and ever (through the eternities of the eternities).

The comparison is obvious. One can practically hear this passage sounding in Ilyich’s ear as he is dying. “There was no fear because there was no death” for Ilyich just as “there no longer exist there anything that is accursed.” Ilyich was redeemed from suffering because death, as a stigmatized or horrific event was now a “light” because “the Lord God” has illuminated both Ilyich and Tolstoy, becoming their light. The redemption almost seems misplaced because the narrator’s tone suddenly shifts from its specific interest to Ilyich’s condition to a broad theological intimation. The narrator, at this point, remains omnipresent but inserts a specific point of view. This confounding technique seems to deny the existence of any specificity with respect to theological perspective. However, this very technique makes the perspective all the more convincing with its own self-denial, which effectively allows the perspective to expand infinitely beyond the limitations of any single religious or philosophical tradition.

As Ilyich demonstrates, one’s passive lifestyle with respect to colossal questions about mortality can result in a swift, nearly undetectable, insertion of a philosophy into that person’s life through the precise facilitation of a highly developed linguistic strategy. With that said, I will now return to the concept of the 18th century Enlightenment movement in philosophy as I consider the dangers of philosophy as applied to end-of-life decision making in the public sphere. During the time of the scientific revolution, the Enlightenment movement brought about an international celebration throughout the West of reason and rational thought. This celebration came about in response to enormous scientific discoveries, such as controlling and suspending light with electricity and the transportation of goods and people at an unheard-of speed prior to the new invention of the railroad system. The controversial debate regarding standardizing a definition of death or the creation of a single philosophy addressing multicultural pluralism and death has been addressed in the President’s Commission for the Study of Ethical Problems as quoted in DeSpelder and Strickland:

The president’s Commission for the Study of Ethical Problems in Medicine said that the Uniform Determination of Death Act “addresses the matter of defining death as the level of general physiological standards rather than at the level of more abstract concepts or the level of more precise criteria and tests, because such standards and criteria change over time as knowledge and techniques are refined. (DeSpelder and Strickland 165)

To draw again from the Enlightenment movement in philosophy, the approach to end-of-life issues with “general physiological standards” is in accordance with the Enlightenment philosophy, which prefers objective scientific method with testable results. Much like Barry’s philosopher has his or her own tradition of philosophy, the President’s Commission too is assuming a tradition of philosophy specific to the 18th century Enlightenment movement responding to and celebrating the scientific revolution. The physiological standards assume the academic standard I mentioned earlier. This standard can be understood as the governing principle keeping consistent the contribution of knowledge with respect to the discipline of Physiology which itself is sprung from a tradition, specifically the 18th century Enlightenment movement in philosophy and the subsequent creation of the modern university.

With respect to controversial topic of end-of-life issues, the primary realm demanding reformation is the economic factors influencing personal decisions about dying. When considering a pluralistic society, moral considerations are not an adequate discussion for policy regarding death and dying. As I have shown, philosophy is a term that is often misused. To approach the topic of death on a broad level, addressing every perspective of death is inconceivable. Each perspective has it’s own history, tradition, relevance, and vitality. Barry’s derogatory use of the term “ordinary” is an attempt to suppress various traditions in favor of one single tradition. Attempting to create or facilitate a single philosophy with respect to mediating all of the others when offering treatment or technology will only result in the domination of a single tradition over all of the others, much like Dostoevsky’s tyrannical underground.

One may argue that the consolidation of ethnographic papers discussing various interpretations of death would be a solution to addressing a multitude of theologies and philosophies with respect to dying which influences end-of-life decisions. However, this is a problematic solution because, again, there cannot exist a rational method of organizing cultural data because imposing rationality to varying and often clashing interpretations of death attempts to suppress variation and favor the Enlightenment philosophy of reason and the scientific method. Again, we can think back to the underground man’s attempt to organize his conflicting interests with some rational method, i. e. time, which was completely futile. Furthermore, in the case of the development of the most sophisticated method imaginable when organizing cultural data; I would argue for a skeptical position because no conceivable method could account for author biases, erroneous research methods, and the very nature of cultural and philosophical flux, which would essentially exceed the limits of representation despite of the most advanced and precise scientific methodology.

Socialism in Lieu of the Guiding Moral Principle

Engels, paraphrasing Feuerbach articulates, “ philosophy is nothing else but religion rendered into thoughts and thinking expounded” (Tucker 107-108). Furthermore, “the concepts of good and evil have varied so much from age to age that they have often been in direct contradiction to each other” (Engels in Tucker 725). Philosophy and religion may as well be synonymous since both provide elaborate answers to grand metaphysical and existential questions. No single approach is better than the other. “General physiological standards” does not neutralize “abstract concepts” or “precise criteria and tests” (DeSpelder and Strickland 165) because general physiology, when defining death, is another philosophy in and of itself that can suffocate or extinguish other philosophies interested in their own respective definitions of death. Wildes argues, “we should allow individuals to choose their own definition of death based on their own moral convictions” (Wildes). I agree with this claim and I would extend it to include that moral philosophy as it stands today should be left for the private sphere, completely out present political and bio-ethical debate.

As I do not have a revolutionary manifesto readily prepared to argue for a solution to the current political economy, I would venture to agree with Marx in the sense that “political economy—despite its worldly and wanton appearance—is a true moral science, the most moral of all the sciences. Self-denial, the denial of life and of all human needs, is its cardinal doctrine” (Marx in Tucker 95).

I would also agree that the “denial of life,” as the “cardinal doctrine” to the political economy, as Marx puts it, is evident in the sense that cultural variability is denied when the political realm takes on the topic of moral philosophy in order to standardize understandings of death. As Epstein points out, historically bioethics has failed to address the economic factors that influence decisions regarding death do to the social stigmatization of death and its relationship to economic factors. Marx explicates this stigmatization:

Since money, as the existing and active concept of value, confounds and exchanged all things, it is the general confounding and compounding of all things—the world upside-down—the confounding and compounding of all natural and human qualities. He who can buy bravery is brave, though a coward. As money is not exchanged for any one specific quality, for any one specific thing, or for any particular human essential power, but for the entire objective world of man and nature, from the standpoint of its possessor it therefore serves to exchange every property for every other, even contradictory, property and object: it is the fractionalization of impossibilities. It makes contradictions embrace” (Marx in Tucker 105).

Marx, like Epstein, asserts that rather than the traditional poet or individual speaking from any number of cultural backgrounds makes his her her own decisions about death, about life, about anything, really—from the perspective of the cost of each respective decision.

Back to the Bible, a solution to the economic aspect of dying is proposed:

Come! And let him who is listening say, Come! And let everyone come who is thirsty [who is painfully conscious of his need of those things by which the soul is refreshed, supported, and strengthened]; and whoever [earnestly] desires to do it, let him come, take, appropriate, and drink the water of Life without cost.

The omniscient narrator suggests that we consider the material state of things in order to improve life. I add that the improvement of life will then eventually lead to better deaths. Rather than our letting our bioethics and policies reach out into the dark with eyes blindfolded, let consider the impossibility and danger of trying organize every perspective of death into a single universal standard of death.

Conclusion

People should be given the space to make up their own minds about dying because they already do anyways. The debate regarding end-of-life issues should switch gears from the philosophical realm to the economic side. The focus of the debate in bioethics should be not how to define death in a general sense, how to standardize the use of technologies delaying the death process, or how to standardize the way people will be allowed to die; but instead be creative itself and develop a new approach to economic factors of dying. Bioethics should consider its own history, which leaves out economic factors as they relate to end-of-life decisions, as Epstein argue.
We are a society largely denied monetary wealth since a small fraction of America’s population owns most of the total income earned in the United States. As Marx points out, people buy “bravery” if they want bravery (Tucker 105). In a sense we express our identities by the products we buy which makes our existence highly dependable on money. Wouldn’t then our death too depend highly on money? Death with dignity or dying a peaceful death implies that our financial situation must be satisfactory. As we leave our loved ones on earth, we must know that they will be in good economic standing. We might even find that our very existence near the end of our lives might in fact deny our loved ones of large sums of money or even burden our loved ones immensely with respect to the high cost of dying. In order to standardize a good death, the government must leave death up to us, each individual and each cultural perspective of death and the moral codes that follow, and instead focus on aiding us with our decisions about death rather then encouraging us to make decision about money while the government makes decision about our own deaths.

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