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Living alone and dying alone: a dark side to longevity

December 21, 2021

This story is from Swedish Television (SvT) about the increasing number of people found dead in their homes long after they have died. I suspect it is not an uncommon story in modern societies where longevity has increased sharply in the last 100 years. Western Europe and Japan are also places where the twin challenges of aging and population decline will be the new challenges for society. But the loneliness of the elderly is primarily a consequence of longevity. I also suspect that it may be somewhat accentuated in Sweden where the fixation on youth may be the reason for the elderly gradually becoming second class citizens.

Homes for the elderly have become places where people are sent to be forgotten and to slowly fade away without any fuss. Here too they actually die alone even though they may be surrounded by strangers within a faceless system of care.

SvT News:

SVT’s survey shows that since 2018, more than 400 people have been found lying dead in their homes at least a month after having passed away. Over ten of these had been dead for more than a year before they were found. “Many times dogs are found dead right next to their master or mistress. Animals are very faithful”, says Östen Sahlén, who has been transporting corpses for half a century. He faces death every work shift when he picks up deceased people on behalf of, among others, the Police Authority. They are often people who have been dead for a long time.

“It can vary from days, weeks, months or years. The longest I’ve been through was a person who had been lying dead for three years”. His rent had been fully paid by direct debit. SVT followed a pick-up in Nynäshamn where a body was to be transported to Stockholm for an autopsy. “The smell, this sweet and sour smell you come across. I don’t think you can really get used to it, you can live with it but not be unaffected by it”, says Östen Sahlén.

In November, a deceased man was found in southern Stockholm – and the indications are that he lay dead there for over two years. The rent was paid via direct debit and the landlord Stockholmshem said that therefore they had had no reason to contact the man. The bailiff, on the other hand, tried to get in touch with him in the autumn of 2019 due to an unpaid TV fee. When they did not receive an answer, they instead went into his account and collected the money. By then, the man was probably already dead.

SVT’s survey, using data from the National Board of Forensic Medicine, shows that over 400 people had died in their homes at least a month before they were found during the years 2018 to 2020. More than 100 had lain dead for over three months and at least ten for over a year before they were found.

“There can be piles of mail and advertising inside the doors that we need to move away to get in. This is the dark side of society. I feel a need to pick up those people so that they do not have to lie there in their loneliness. I do not think you should have to disappear in this way”, says Östen Sahlén. A case that has received much attention in recent years concerns a man in his 80s who was found dead in his apartment on Södermalm in Stockholm in the autumn of 2019. He had been dead for almost four years.

Related:

Dwindling peers or the loneliness of the long-distance survivors

 

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Covid puts ethics under pressure in Sweden

July 18, 2020

The Wuhan virus pandemic is bringing many ethical questions about the treatment of the aged into stark relief.

90% of all deaths in Sweden due to the Wuhan virus have been of those over 70 years. I have been less than impressed by the Government and the National Board of Health and Welfare (Socialstyrelsen) in Sweden. Their “remaining useful life” criterion is rational but hypocritical in trying to maintain the pretense of it not being age discrimination. They have effectively removed those over 70 from their definition of the herd to be protected. Even the trade unions were extremely concerned about protective equipment for their members working in the care sector. They threatened to strike at some care homes. I suppose that very few inmates of the care homes are active trade union members.

Suspected cases in care homes were usually kept away from the health care system and its facilities. The health system was under stress but never overwhelmed. Isolating those over 70 certainly helped reduce the pressure on the health services, but did not protect the over 70s from themselves being infected in their care “prisons”. In most cases the inmates were infected by their carers. However, unlike the inmates, the carers had recourse to the hospitals. The isolation also eliminated – probably as intended –  any chance of the +70s participating in any herd immunity that may develop. In the fight against the Wuhan virus, “Official Sweden” (from government to bureaucrats), has taken the position that the over 70s are not part of the herd and are expendable.

Take this ethical question:

When an 80+ year old in a care home contracts a treatable condition (bacterial pneumonia for example), but is misdiagnosed (assumed) to have the Wuhan virus and, without any further testing, is put on “palliative” care (morphine) leading inevitably to death, is it 

    1. unfortunate accident? or
    2. humane care?, or
    3. negligence?, or
    4. incompetence?, or
    5. euthanasia?, or
    6. justifiable manslaughter?, or
    7. murder?

“Official Sweden” has generally taken the comfortable position that such cases  – and there are more than a few – are all “unfortunate accidents”. I would put it less complacently at 3 on the list above or even higher.

The nice thing about “unfortunate accidents” is that nobody is accountable and nobody needs to take any responsibility.

 

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Going raging into the night

August 23, 2018

My introduction to Dylan Thomas was as a teenager. I heard Richard Burton reading “Do not go gentle into that good night” on radio (though as with all things Burton, “declaiming” would be better than “reading”) in the 1960s. Then I watched Under Milk Wood in the West End and I fell in love with the sound of Dylan Thomas. I read all I could find of his and I read them aloud to myself (irritating my room-mates at my students hostel no end). But it was very much later that I penetrated beyond the mesmerising, chant-like quality of the sound and began to understand the words.

But I observe that my understanding of (or more correctly the meaning I ascribe to) his writings are changing with time. At one time I saw “Do not go gentle ..” as an exhortation and a plea to an old and dying man (his father) to not give up; to keep fighting; to not go quietly. The poetic form used is a villanelle which is a nineteen-line form consisting of five tercets followed by a quatrain. The two repeating refrains are both hypnotic and melodic.

But understandings shift and now, that I have passed 70, I read it much more personally. I take this poem as being addressed to me.

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.
Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.
Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.
Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.
And you, my father, there on the sad height,
Curse, bless, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.
Of course Dylan Thomas has to be read aloud and of course he chooses words for the sound as much as for the meaning. What gives me most satisfaction now is that I am still conscious. It is not a rage against dying but it is a rage against the dying of the light. “Old age should burn and rave at close of day”.

Richard Burton reading Dylan Thomas’ “Do not go gentle into that good night”

 

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Dwindling peers or The loneliness of the long-distance survivors

January 15, 2018

The global crude mortality rate is just under 1% (around 8/1,000 in developed countries with some countries up to about 15/1,000). As population ages the global rate will be around 9-10/1,000 by 2100.

Of those aged 50, the annual mortality rate is about 300/100,000. By the age of 60 this has increased to about 800/100,000 and then increases sharply to around 25,000/100,000 by 90 and encompasses virtually everybody by the age of 100. (There are currently about 300,000 people world-wide who are 100 years old and a handful who have reached 115 years old). On average women live around 4 -5 years longer than men.

Defining “peers” to be those of a similar age, I assume that most people probably reach a maximum number of peer-acquaintances at a little over the age of 50. In my own case I would guess that this was probably when I was around 55.

An increasing mortality then applies to a dwindling cohort of peer-acquaintances. The longer one survives the faster one’s peer-acquaintances shrivel.


Setting peer-acquaintances to be 100% at 50 (and ignoring accretion of new peer acquaintances), their number has dropped to around 80% at 70, and have halved by the time one has reached 80. At our 50th school graduation anniversary when we were all around 65, around 10% of our classmates had passed away. By the age of 90, peer-acquaintances have dwindled to less than 10% of those who were alive at 50. Those who live to 95 have virtually no acquaintances of their own age left alive.

For those who survive to 80, half their peers have died by then. Loneliness is I think governed, not by the number of people surrounding you, but the number of peers one can communicate with. It is a cliche of course, but the longer you survive the dwindling number of your peers ensures the increase of your loneliness. If loneliness is inversely proportional to the number of peer acquaintances, then between 70 and 90 loneliness increases by a factor of 8.

 

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Safest drivers are aged 75 and the young are much riskier than even the 90-year-olds

August 20, 2017

Age discrimination against the elderly is widespread and institutionalised in Europe.

There are calls in some countries (including Sweden) for elderly drivers to be retested. Sweden does suffer from a youth fetish and the experience of the elderly is often wasted and replaced by younger incompetence. Yet, the statistics do not support these bigoted calls.

Aftonbladet:

Above 80, the risk of causing a traffic accident increases. But those who call for testing of the  driving ability of the elderly have not studied the statistics. The risk of a traffic accident is least at 75, according to insurance claims statistics. ………. 
By a long way the really young have the highest risk of causing a traffic accident with their own car.  The risk that an 18-19 year old will cause a car accident is 3.5 times higher than the average. The risk then falls sharply down to around twice the average at the age of 30 according to the claims statistics of the insurance companies. These are statistically sound figures, largely confirmed by Folksam, taking into account, for example, that older people drive less. From around 40 to 80 years, the risk is close to the average. The lowest risk behavior is reached at 75 years, when the risk of having a car accident …. is about 20 percent lower than the average before it rises again and increases with age. …… 
But even though the risk increases at the end of the age curve, a 90-year-old is no more dangerous in traffic than a 35-year-old.  Last year, the Transport Agency initiated an investigation to see whether the regulations should change. One way to go is mandatory health checks at a certain age, another is an extension of the doctors’ reporting obligation. According to the Transport Agency, the investigation is expected to be completed sometime in spring 2018. But Tania Dukic Willstrand, who is studying the elderly in traffic at the State Road and Transport Research Institute (VTI), is doubtful. Other countries have introduced mandatory tests by elderly drivers. “And it has not shown increased road safety,” she says. 
Those over 80, just as younger drivers, pay a higher premium for insurance as a reflection of the risk. Even 40-50-year-olds have slightly higher insurance rate. “It’s the age when the youngsters begin to borrow mothers and dads cars,” said Dan Falconer.

Data from the US also shows much the same thing. The safest drivers are around 75 years old. But even at 90 years old they are much safer than the 18-19 year old drivers. (AAA study).

 

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When acquaintances pass away

June 28, 2017

The bulk of those we “know” are acquaintances and they may number from several hundred and up to a few thousand.

If the Dunbar Number postulation is correct, we can have strong, stable, close relationships with about 150 people (minimum about 50 and maximum about 250). We  can also “feel” strong, one-way relationships with a few public figures we may never have met, and who may not even be aware of our existence (musicians, actors, politicians ….).

When somebody close passes away the measure of our grief and our reactions is dominated primarily by the closeness of the relationship and then by the circumstances surrounding the death. This has probably been much the same for humans through most of history. However it is our reaction to the passing away of acquaintances which may say more about our changing attitudes to life and death.

I am of an age now where hardly a week goes by without the passing away of an acquaintance. I am also of an age where new acquaintances come slowly. So my circle of acquaintances is beginning to reduce. Trying to observe myself, I would generalise my reactions to the death of an acquaintance as follows:

  • Less than 50 years old : Futility, cruel, tragically young
  • In their 50’s                   : Sorrow, regret, before their time
  • In their 60’s                   : Sadness, misfortune, not very old
  • In their 70’s                   : Regret, it happens, a good innings
  • In their 80’s                   : Acceptance, acceptance, acceptance
  • In their 90’s                   : Acceptance, celebration, a long span
  • In their 100’s                 : Wow! Was he/she still alive?

Of course the circumstances of a death also play some part in the reaction  – but not so much, it seems, once an acquaintance has passed 80. The same kind of tragic accident which takes the life of a 50 year old, seems not so tragic when an 80 year old is the victim. A few months ago a good acquaintance died in his 50’s following a bicycle accident, and it all seemed such a terrible waste. About a year ago an 83 year old acquaintance also died following a bicycle accident, but his death did not seem as tragic, and even included a hint of “what on earth was he doing on a bicycle at that age?”

I suppose it is because the probability of an 80 year old dying is so much higher than that of a 50 year old. Our sense of regret and loss reduces as the probability of death increases. The circumstances surrounding the death seem less important.

At 50 the probability of death is about 1: 300 but at the age of 80 this has increased to 1:20.

UK data image bandolier

Our reactions, I conclude, are probably strongly influenced by the probability of death of that acquaintance. As longevity changes, the probability of death changes, and our reactions follow suit.

 

 

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The “design life” of humans

March 25, 2016

The “design life” of a component or system is generally a boundary condition before starting to design. It is an inherent part of the design. The human body can be taken to be a system based on the organs as major components and a myriad of other components. Our genes are the design for our bodies and they exhibit a “design life”. Whatever we may assign as the purpose of our DNA, our bodies exhibit a design life of between 50 and 60 years. 

In engineering, when an artefact or component or system is created, it is quite usual to have a “design life” as one of the key boundary conditions for designing the artefact. The artefact-lifetime to be designed for determines the choice of materials for strength and resistance to corrosion and erosion, and for their cycling properties and their resistance to fatigue and creep. The lifetime to be designed for leads to a choice for the level of redundancies to be included, the ease of maintenance to be allowed for and a choice of a maintenance strategy which includes a replacement “philosophy”. The “design life” is then usually defined as the time for which the artefact will be fully functional and can often be the lifetime guaranteed by the manufacturer. The designer makes his choices based on the probability of failures. For example the quoted design-life may be based on the time when the probability of failure or loss of functionality is – say – less than 10% or 1% or 0.1%.

The concept of “design-life” is different to the concept of “obsolescence” or the “mean time between failures” (MTBF). Obsolescence, whether introduced intentionally or not, is the time when when the defined functionality is no longer relevant. It could be intentionally “built-in” as a marketing strategy or it may result from the appearance of new technologies. The MTBF is a measure of the time between random – not due to wear – failures of a particular component. The MTBF of single components will generally be orders of magnitude longer than the design-life of that component.

Most components or systems can – with proper maintenance – be used with full functionality long beyond their quoted design life. A power plant may have a design life of 25 years, guarantees for only 2 years but may be used for 50 or 60 years. A digital camera may have a design life of 5 years but could be obsolete after just three. A Swatch may have a design-life of 5 years and materials to suit, whereas a Rolex may use materials and manufacturing quality to be able to come with a lifetime guarantee (with suitable caveats for the user’s negligence). When analysing reliability, the life of components and systems is often illustrated by the generic “bathtub curve”, where the total failure rate is given by the addition of random failures, failures due to “infancy problems” and failures due to wear. Infancy issues are those which are caused by quality of materials, manufacturing tolerances, manufacturing processes and the like.

Modes of failure

On the bathtub curve the design life used to create a design will always fall within the section where the total failure rate is at its lowest – that is after the initial period where “teething” and other infancy problems arise and before the sharp increase in failure due to wear. Generally, to change the design life the basic design itself must be changed.

Consider the human body as a system where the organs are the key components making up the system. The functionality of human organs and of different human functional abilities also exhibit a form very similar to a reversed “bathtub” curve. Failure of a human body occurs when one or more of the functionalities falls below some threshold minimum. In the diagram below, the shaded area represents the behaviour of most organs with age. The lines represent the variation of some of the complex human functional abilities with age.

Functionality of organs with age

Functionality of organs with age

The reverse bathtub curve suggests that the human body has a design life of between 50 and 60 years.

“Infancy problems” in this context include birth and genetic defects which can influence the development and failure rate of organs. “Wear” would be the physical and mental wear and tear but would now also include the effects of aging which curtail the replacement of cells. Average, global, life expectancy is now around 80 years and the longest verified age is about 122 years. Average life expectancy has increased over the last 200 years at the rate of about 3 months every year. Over the next 100 years this may level off to perhaps add another 20 years to life expectancy. Already in 2012 the UN estimated that there were more than 300,000 centenarians alive. By 2100 perhaps global life expectancy would have reached 100 years and the maximum age attained may then be around 140-150 years.

Using the engineering analogy, the main advances in life expectancy have so far come due to improving maintenance and replacement processes but have not improved on the “basic design”. The “improved quality” at birth and in infancy and medical advances have meant that “maintenance” processes have improved drastically. Modern health care is to a large extent the application of “preventive maintenance”.

But, the the basic design is unchanged. The materials used in making up the human body have not changed but “maintenance and repair” strategies have improved out of all recognition. The life of our various organs have not changed inherently, except as a result of the much improved maintenance regime. With no change in basic design, the design life has not changed either. The increasing lifetime of the system (the body) is now beginning to approach the lifetime of the components (the organs) it is made up of.

Currently the design life of a human body could be said to be about 50-60 years. Studies suggest that though we live longer we also have longer periods at the end of our lives when our functionality is severely impaired. The ” basic design” has not changed and the “design life” is not increasing. Life spans of 200 years will not be possible without some change in the “basic design”. For our design life to change it will need advances which allow our cells to keep replicating without the aging effects of the shortening of the telomeres. When that happens (not if), then we would effectively have altered the “basic design” of the human body and its design life.

 

 

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Sweden’s welfare society is often heartless to the elderly

December 4, 2015

Sweden has a well developed welfare state and longevity is high. But, I sometimes feel, those of the elderly who do not have private means, can expect to be hidden away from the general view and encouraged to fade away.

Age discrimination is endemic. The country has a youth fixation and this leads to a deep-seated and widespread discrimination against the elderly. Generally, once a person is labelled a “pensioner” at 65, the journey to being a non-person begins. Only those with private means have some chance of escaping the solitude and invisibility forced upon them. The elderly are grossly under-represented in parliament. The population over 65 is about 26% but the number of members of parliament over 65 is just 2.6%.  Instead of utilising the wealth of experience and knowledge available, parliament has more than its fair share of incompetent youngsters. (This is in spite of the critical faculties of the brain not being fully developed till about the age of 25). It is more expensive for employers to hire seniors even under this red/green government, for who “self-employment” is a dirty word. The prejudices against the elderly show up even in the health and welfare services. The services for the elderly have become dominated by the cost to fulfil the law and are not really concerned with any other measure of quality. Elderly people are often subject to a form of unconscious triage and receive inferior health care. The laws are ostensibly very friendly to the elderly but are administered often by very indifferent (if not unfriendly) people. It is generally assumed that the law – which should be a minimum requirement- is actually a sufficient assurance of quality. The “friendliness” of the laws and the assumed quality they “assure” is used to assuage the conscience of society as the elderly are hidden away in homes and encouraged to fade away with as little fuss as possible.

Every so often a case gets attention which demonstrates the impersonal and “heartless” nature of the welfare services for the old who do not have private means.

Expressen: Siv and Nils Sundén, 72 and 86, have lived together for over 40 years. But now Stockholm City is forcing them to stay in different homes for the elderly – even though it is against the law. “We do not have many years left so it is important to be together”, says Nils Sundén. 

A couple who have long lived together have the right to continue living together, even if they have different care needs. This law, of the right to cohabitation, has been in force since November 1, 2012. However few make use of it. …..

“We’ve been married for over thirty years. When we first moved from our villa, we came to a retirement home in Blackeberg. I lived in a group home and Siv got an apartment in the same house”, says Nils Sundén.
But the nursing home had shortcomings and the married couple were forced to move to two different homes for the elderly in early 2013. In May, the couple asked about getting to stay together, but this was rejected by the Assistance Unit within the City of Stockholm, which decided  on the matter. Siv and Nils Sundén were denied the opportunity to live together and the official wrote, 
“Joint living is not deemed to be appropriate in the nursing and care homes with dementia orientation unless both spouses have need of such accommodation.” …..

Dick Lindberg is an investigator at the National Social Services Board. He has been commissioned by the government to guide municipalities on how to apply the new law on cohabitation. He has followed the work of the law and written inquiries on the issue since 2012. He was very surprised that Nils and Siv Sundén had been refused the chance to stay together. “It sounds a bit strange. The whole point (of the law) is that it applies to spouses with different care needs. Even if one of the pair is completely healthy they should be able to stay together anyway. Moreover, there is no exception for people with dementia”, said Dick Lindberg.

The couple were first denied the chance to stay together because he lived in a dementia home. Which he does not. Then they were denied on the grounds of the health needs of one of them, which is not valid as a reason for denying that the couple live together. …..

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UK longevity increasing faster than national statistics forecasts

April 30, 2015

The rule-of-thumb is that average longevity in a developed country increases by about 1 year every 25 (4 years every century). So in the year 2500 an average longevity should be well over 100 years. It has been postulated that that this rate of longevity increase will decrease as we approach some kind of asymptotic “maximum possible” age – variously proposed to be 100, 150 or even 200 years. But it seems that the understanding of how telomeres affect cell aging and cancer is also fast increasing. If medical science develops to the extent that key cells can be encouraged to renew themselves in a controlled manner (by not reducing the telomere tail in a cell’s DNA with every replication) and yet not succumbing to the risk of uncontrolled growth (cancer), then a human longevity of even 500 years  does not seem impossible.

After 2100 the world will be faced with a fertility rate below replenishment levels and one way of mitigating the effects of a declining population will be an increasing longevity and a corresponding increase in the span of the “child-bearing” years (which in turn will correct the fertility decline). The challenge is going to be in arresting the decline of human faculties. If that is achieved it will automatically increase the “productive life span” and balance the critical and currently declining ratio of productive population to supported population.

A new paper in The Lancet suggests that official statistics in the UK are underestimating the rate at which longevity is increasing. 

J.E. Bennett et al. ‘The future of life expectancy and life expectancy inequalities in England and Wales: Bayesian spatial forecasting of population health.’ Lancet, 2015. http://dx.doi.org/10.1016/

Imperial College has put out a press release:

A new study forecasting how life expectancy will change in England and Wales has predicted people will live longer than current estimates.

The researchers say official forecasts underestimate how long people will live in the future, and therefore don’t adequately anticipate the need for additional investments in health and social services and pensions for the elderly.

The new study, published in the Lancet, also predicts that regional inequality in life expectancy will increase, highlighting a need to help deprived districts catch up with affluent areas.

Researchers at Imperial College London developed statistical models using death records, including data on age, sex, and postcode, from 1981 to 2012 to forecast life expectancy at birth for 375 districts in England and Wales.

They predict that life expectancy nationally will increase for men from 79.5 years in 2012 to 85.7 in 2030, and for women from 83.3 in 2012 to 87.6 in 2030. The longevity gap between men and women has been closing for nearly half a century and will continue to get narrower.

The forecasts for 2030 are higher than those by the Office of National Statistics, by 2.4 years for men and 1.0 year for women. …

During my life-time, “middle age” has shifted from 40 years to be now around 50. For my children “middle age” will probably be at around 60.

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“Euthanasia is both profitable and cost effective”

July 28, 2014

I think an individual should be able to choose, and be assisted, to die peacefully and painlessly – provided he is of sound mind and is suffering from a terminal and painful illness.

But I am afraid that part of the building momentum for euthanasia in Europe is cost driven and not driven by a concern for the individual. Countries with aging populations and with well developed public health programs are facing increasing costs for the care of the elderly. In Sweden and the UK for example this care is often “out-sourced” or privatised. Many of these establishments are owned by risk capital companies – which is a little strange – but not fundamentally wrong. But the “quality” requirements they are required to meet are set by the public institutions doing the out-sourcing. Inevitably these “quality” requirements are specified in such a way that the out-sourcing succeeds and contracts are let. To ensure this the requirements always allow the service provider sufficient room to make a profit. There is a clear incentive for the service provider to “increase the throughput” and reduce the cost per person they are tasked to care for. That – in turn – is leading to a deterioration in the care provided especially to the aged who are no longer competent or able to complain about the service received. It is clearly cheaper to allow a general reduction of service, and to only do more than the minimum if and when a complaint from a relative is received. Of course, relatives have only limited opportunities to notice any deterioration of service. The “out-sourcing” itself is driven by cost. There have been many “scandals” (such as this one) associated with the “quality” of service in “privatised” homes for the aged. But it is not by accident that the State and the municipalities and health authorities have pushed these scandals into the “privatised” sphere rather than to be found wanting themselves. Part of the reason for out-sourcing these services has clearly been to also out-source the scandals waiting to come as care of the elderly inexorably deteriorates. The more the care of the aged deteriorates the more attractive a voluntary euthanasia scheme becomes – for all parties involved.

I have a clear perception that in Sweden the quality of public medical and palliative care for the elderly is already driven by cost considerations. It is illegal in Sweden but age discrimination is endemic. We hear about procedures and expensive treatments being denied to the elderly for many ostensible reasons, but in reality because the patients are – in the judgement of the care-providers – just too old and too big a drain on costs. For public medical and palliative care, a form of unwritten age-discrimination is already in place. The aged patient has little recourse except to opt for private treatment and then euthanasia may be a much more cost effective solution..

The euthanasia debate is picking up steam in Europe but my fear is that though much of it is carried out under the guise of concern for an individual’s right to die, much of the debate is actually being driven by public health cost considerations. Many of the statements by politicians seem to me to be trial balloons or electoral posturing – but they have an underlying smell of preparing for curbing the costs of caring for the increasing number of the elderly.

It may be very cynical but I note that a healthy growth rate in voluntary euthanasia among the aged has many public and social and economic benefits. The cost of health care for the aged is both capped and reduced. The demographic of the ratio of elderly to working population is improved. Medical resources are freed for the more valuable, younger patients. And the aged patient gets what he or she wants.

A true win-win!

BioEdge: 

Euthanasia might be needed for poor people who cannot access palliative care, the new Lithuanian Health Minister has suggested. Rimantė Šalaševičiūtė was sworn earlier this month, but already she has made waves by backing an open discussion of the legalisation of euthanasia.

Without making any specific proposals, she told local media that Lithuania was not a welfare state with palliative care available for all and that euthanasia might be an option for people who did not want to torment relatives with the spectacle of their suffering.  

The minister has also raised the idea of euthanasia for children. She noted that this option had been approved for Belgian children after a long public debate. It was an option which might be appropriate in Lithuania as well after public debate.

Ms Šalaševičiūtė will face an uphill battle in her campaign to introduce Lithuanians to euthanasia. Many doctors and the Catholic Church oppose it. Dr Andrius Narbekovas, who is both a priest and a doctor, and a member of the Health Ministry’s bioethics commission, told the media:

“The Ministry of Health should protect health and life, instead of looking for ways to take life away. It goes without saying that it is … profitable and cost effective … But a democratic society should very clearly understand that we have to take care of the sick, not kill them.”

Lithuania merely reflects the debate all over Europe which is probably most advanced in Belgium where even involuntary euthanasia (is that not murder?) has been proposed.

Politicians and many aged sufferers could find this irresistible: “Euthanasia is both profitable and cost effective”.

Two of my friends have utilised the services of Dignitas. So, for whatever reasons it may come, I do hope that voluntary euthanasia is available to me when my time comes.

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Posted in Aging, Ethics, Europe, Sweden | Comments Off on “Euthanasia is both profitable and cost effective”

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