The Moral State We’re In. Julia Neuberger
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The argument here is that it is the shortening of the period of working life that is likely to be the cause of difficulties, in financial terms, rather than demography per se. There is plenty of evidence to support this theory. The Chartered Institute of Personnel and Development (CIPD) surveyed its members, arguing that Europe’s population would age faster than almost anywhere in the world, and found that two out of every five workers felt they had been discriminated against on the basis of age. Older people are seen as doddery and out of touch, whilst the young are seen as immature and unreliable. In looking at the data, Patrick Grattan, Chief Executive of the Third Age Employment Network, identified the media, fast-moving information technology, financial services, and manufacturing as industries that have yet to embrace an equal age policy.* Mike Saunders, the 66-year-old owner of an employment agency entitled Wrinklies Direct, argues that older people also sometimes lack the right attitude at interview, arguing that ‘They have to sell their experience; they have to stand up against the young and be counted.’ There is cynicism amongst employers, too. Older workers in traditional sectors like banking tend to have built up expensive employment rights, such as increments and pension entitlements. By making people redundant early, firms save themselves a lot of money.† Nor are government schemes particularly effective: ‘New Deal 50+’, launched in 2000, is open only to those already on benefits, rather than to all those over 50 who are finding it hard to get new jobs.‡ Even more significantly, Mullan argues convincingly that the fear of the demographic time bomb, rather than its actuality, is what promotes insecurity and a lack of inter-generational trust. If older people cannot trust the next generation down to look after them when they are frail and dependent, an increasingly individuated way of caring for oneself will develop. Meanwhile, if the next generation down fears that the older generation will consume all the assets of the family or the state, then respect and care are likely also to be in short supply. This truly is a vicious circle, and Mullan is on to something when he points to the fear of the demographic time bomb as an example of the generalized lack of trust between individuals in our society, particularly between the generations.
So the responses to this apparent demographic threat are many and numerous. Some say that this supposed time bomb is not all it seems because the UK will be importing a huge amount of labour from overseas to carry out the caring jobs and to feed our economic growth. According to this argument, the panic is unreasonable, we should stop worrying and simply get on with providing better care for very frail older people. At the other extreme is the enormous change in attitude, both in younger and older people, towards the euthanasia argument.
Euthanasia/Assisted Dying
There is a view expressed by some that there is no need to have ‘useless’ old people around who can no longer make a contribution to society. Though no one is suggesting that they should be forced to die, there are some who think that it should be possible for them not to have to continue living if they do not wish to. These are people who might be said to be arguing for euthanasia on the grounds of age and uselessness.
At its most extreme, the ‘uselessness’ view is one that could be compared to that held by the Nazis about people with severe mental and physical disabilities. There was already a respectable view of ‘mercy killing’, as propounded by Ernst Haeckel (1834–1919), the scientist and philosopher. So when the Nazis came to power in Germany, they set up the General Foundation for Welfare and Institutional Care, or T-4 as it came to be known, made up of doctors and psychiatrists, and carried out 70,000 killings of men, women, and children in institutions before the programme was stopped as a result of protest, largely from clergymen.
Obviously, those who are in favour of euthanasia for older people have no desire to go that far. But in arguing that very frail older people are of no use to society they are going down that road, though they would naturally be appalled at the comparison. Their aim is to make it respectable for older people-particularly those who really are near the end of their lives, who are suffering, and whose continuing care is costing the health and social services considerable amounts of money and resources–to ask for euthanasia. In order for that to happen, it has to become morally acceptable to eliminate (with their consent) older people who cost the state too much to maintain.
Other countries have euthanasia, after all. In Holland some argue strongly in its favour, whilst others are far less happy about it. Bert Keizer, a physician in the Dutch state-run nursing home system who has written extensively about death and dying, argues that there is virtually no abuse of the system and that people themselves do genuinely ask to be put out of their misery.*
The Dutch Catholic Church tends to take a different view, claiming that children put pressure on their parents in order to inherit. It has to be emphasized, however, that, unlike in much of the UK (Scotland being the exception), nursing home care is free in Holland and there is little in the way of private-sector provision. So how strong is the pressure from children likely to be once elderly parents are ensconced in a free nursing home, when they have reached a stage where relatives can no longer manage to provide care at home?
In Britain, on the other hand, the bulk of nursing home care for older people is provided by the private sector and children may well see their parents’ nest egg, which they often regard as theirs by right, swallowed up in nursing home fees. Parents certainly have a strong desire to pass on their wealth and savings–and often the house they live in–to their children. The result is considerable anxiety about the lack of free provision and about the need to draw down on savings. Anyone who has capital of their own above £20,000 will be assessed as being able to pay the standard rate. In the case of a care home providing nursing care, this would be the fees less the contributions the NHS might make towards the cost of nursing care. Those whose capital is between £12, 250 and £20,000 will be expected to make some contribution from their capital on a sliding scale, until the capital goes down to £12,250. Pensions and provision for older people have become major political topics in Britain, as discussed below.*
Those in favour of euthanasia argue that it might be easier if older people, instead of costing the country so much, could simply ask to have themselves put quietly and painlessly to death before the money runs out. The argument is rarely spelled out that way. But remember the story of the dog, the cat, the donkey, and the cock at the beginning of this chapter. Their owners thought them useless and felt that it would be fine to finish them off. We are not the owners of our older people, but as a society we see them as a problem. Hence the political issue that has blown up over long-term care for older people, which the Labour government promised to sort out on coming to power in 1997. It soon realized that this was a truly difficult task because of the conflicting and complex moral and financial arguments. Are older people entitled to free care by virtue of being old? Or should they pay for their care on the grounds that it is an unreasonable burden to place on the younger people who will end up paying the bill? Should they, in fact, regard it as a normal part of the costs of life?
In this climate of concern about ageing and its costs, the Patient (Assisted Dying) Bill was introduced in Parliament in February 2003 by the cross-bencher peer Lord Joffe. As it did not have government support it had virtually no chance of becoming law. Nevertheless, it was seen as an opportunity to air, once again, the complex and varied views held by all kinds of people and organizations on the subject. It had its second reading, unopposed, in accordance with tradition, in June 2003. After that, significant changes were made to it, to deal with some of the objections. These reduced its scope in a variety of ways, including limiting application of the Bill to terminally ill patients and stating that in assisting someone to die the attending physician might only provide the means to end the person’s life, unless the latter was physically unable to do so, in which case the physician could become actively involved. The idea that the physician would only provide the wherewithal, rather than actually kill the person, had considerable attractions