Sunday, 20 November 2011

Ageing Populations and "The Ballad of Narayama"

Many years ago I saw Shohei Imamura's "The Ballad of Narayama" at Brighton's Duke of York's cinema. It's a beautiful and deeply moving film, set in the past, about a poor rural Japanese society in which the elderly are, by custom and tradition, exposed to die on the bleak mountains when they reach the age of 70. The central drama is between a mother, who believes in the custom, and her son who resists his duty - which is to carry her on her final journey to the mountain. At one point, to make her point that she is becoming useless, the mother smashes her mouth against a stone ledge in order to render herself a toothless old woman.

This Japanese film resonates with elements in Western culture. Think of "Greater love hath no man than this ..." and its exemplary case, Captain Oates, marching to his death in the snow.

In both Japan and the West, life expectancy has risen dramatically in just a short period and continues to rise. It places strains on government budgets, obliged to fund pension payments for many more years than was ever foreseen and to support expensive care for the elderly frail.

There is a lot of publicity around those who take themselves off to Swiss clinics which will help you die but none that I am aware of about those who take less dramatic measures to bring their lives to a close.

I class as the elderly frail those who are in no state either to seek to prolong their lives or to shorten them. But those in a pre-frail state have some choices. Occasionally, they refuse further medical treatment. Occasionally, they live it up and do all the things they have been advised not to. In other words, they do not strive officiously to keep themselves alive. But very rarely do they actually commit suicide.

People grow old at different rates and their circumstances are different: there are now lots of men in their seventies with young children to care for.

But as a general rule, governments should not strive officiously to keep alive the elderly, especially when their quality of life is deteriorating irreversibly. Budgets need to be finite for medical treatment and for care. There should be no funding for research aimed at extending life expectancy. If done intelligently and sensitively, the results would be better than an uncritical policy of keeping everyone alive for as long as possible

1 comment:

  1. In a society where people are increasingly strident in demanding their rights, individuals need to be more realistic in what they can expect. What sense does it make for a significant part of a health authority’s budget to be spent on drugs for one person that will prolong his or her life for no more than a few months?

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