Take our user survey and make your voice heard.
Longevity is a gift. Sixty years ago in Japan, life expectancy at birth was 50; now it’s over 80, and rising – to what? A hundred? Two hundred? Maybe one day we’ll live forever.
But Shukan Post (July 22-29) asks, “Do you really want to live to 100?”
Ask “Shinzo,” a man in his 80s. Unfortunately, he can’t give you much of an answer. He’s too far gone with dementia. His family was caring for him at home, with the aid of a professional nurse. One day Shinzo swallowed something undigestible and had to be rushed to hospital. Doctors saw one solution: pump his stomach. It’s an invasive procedure.
“Don’t,” said the family.
“He’ll die otherwise,” said the doctors.
The family understood that and accepted it, but the doctors refused to be complicit in what, under Japanese law, could, in a worst-case scenario, expose them to homicide charges. The operation was performed.
Another example – less stark. “Kozo,” in his 70s, was getting ready to go out golfing one day when suddenly he was overcome by violent nausea. His wife called an ambulance. At the hospital, doctors diagnosed a cerebral infarction. He recovered, but remains partially paralyzed.
“Listen,” he said to his wife, “if I have another attack, I don’t want them to artificially prolong my life. See to it.”
His wife was horrified: “You’re asking me to commit murder!”
The longevity revolution, in short, has a dark side. It poses some dark questions. At what point does life become torture? And what should doctors – whose mission, after all, is to serve and preserve life – do when that point has been reached beyond any reasonable doubt? Or when it’s been reached in the patient’s mind, whatever doubts others may have?
The artificial prolongation of life which so horrified Kozo generally involves one (or more) of three possibilities: artificial feeding, artificial breathing, and dialysis. It is perfectly reasonable of a patient to say, “Even hooked up to a machine – I’m still alive, I’m still me; I can bear the pain and discomfort, I only want to live.”
But it seems no less reasonable to say the exact opposite – that life in such a state is not life, and if there is no hope of recovery, "I don’t want them hooking me up to any machine.”
A handful of countries and territories have gone far beyond Japan in grappling with this agonizing issue. Holland, Belgium, Luxembourg, Switzerland, Canada and four U.S. states (Oregon, Washington, Montana and Vermont) recognize some among various forms of euthanasia or doctor-assisted suicide.
Shukan Post takes us to a bedside at an assisted suicide clinic in Switzerland. The patient is a British woman, 81. She would have preferred to die at home, but the British medical establishment would have kept her alive against her wishes.
The woman had terminal cancer. The Swiss doctor asked her, “Have you lived a full life up to now?”
“Oh, yes,” said the woman – “a wonderful life. And now that I’m no longer able to live as I want to, I feel the time has come to die.”
She had no children, and her husband had died 10 years before.
The doctor indicated the intravenous tube attached to the woman. The patient herself would perform the action that shut it down.
“You understand,” said the doctor, “what will happen when you open this valve.”
“Yes,” said the woman. “I will die.”
In Japan, “living wills,” in which healthy individuals declare their rejection of artificial life prolongation should they fall terminally ill, exist but are problematic. Only 6% of people over 60 have signed one, and their legal status is so ambiguous, Shukan Post hears from Dr Yuya Suzuki of the Japan Society for Dying with Dignity, that “many doctors are reluctant to terminate care in any case.”
© Japan Today
27 Comments
Login to comment
sensei258
It's not murder if it's his choice beforehand. Many nursing home residents in the US have what is called a Do Not Resuscitate (DNR) order in their records. The choice is made by them, their guardian, or their doctor. It means using no special means (feeding tubes, ventilators, or CPR), and allowing nature to take its course. It does NOT mean "pulling the plug" as it were.
The article also mentions euthanasia, where the patient takes an active role in ending their life. I support people's right to choose, as long as they can make that choice intelligently and on their own.
papigiulio
What a bs. Personally im not looking forward to getting old. No pension, healthcare that is getting worse. I personally plan to tap out around 60/70ish. If the missus hasnt killed me by then that is.
kurisupisu
The long life ascribed to Japanese people can be explained by the widespread insertion of tubes carrying nutrients directly into the stomachs of patients too ILL to feed themselves- the Swiss have got it right!!!!
HonestDictator
Yeah, I'm on the DNR listing in the US in case some accident/situation may cause me to become brain-dead or my body to be dysfunctional without life support.
Personally, I hope I don't live past 80~100 if my health is exceptionally bad. Especially if I'm suffering from dementia and senility or bed-ridden.
Not worth it if you can't "enjoy" living.
ThePBot
If they can find a way for people not to age as fast, I'm all in. But if they try to find a way for people to live longer while getting older, screw it.
wanderlust
Many of the aged people that Japanese TV wheel out periodically to demonstrate their longevity appear to have very low quality of life. Other than sipping a little miso soup or some local recipe that prolongs 'life' they do nothing.
My own parents are both in care in their 80s, mum's brain ravaged by Alzheimers, dad wheelchair bound and totally confused with a different form of dementia; both shadows of the people that they used to be. The lounge in their home is known affectionately as 'God's Waiting Room'. The residents all sit there, staring blankly at a TV screen, and despite the best efforts of carers, are unable to engage with anyone. All of their bodily functions are handled by others, food goes in one end and out of the other, they are washed, dressed, medicated, wheeled around, and then put to bed at night.
That's not living.
Wakarimasen
I'm with Papigiulio. The desire to cling on to life no matter what ones physical or financial condition is one I don't understand.
dharmadan
The moment I can no longer remember loved ones is the moment I want to check out.
GW
Clearly these are important issues for society NOW & need to be better addressed, the current save at all costs for many is the continuation of a HORROR show for the old & their families who have to witness & participate till the end.
Thankfully its starting to change but we need to pick up the pace, far too much SUFFERING going on & not enough living!
MsDelicious
I highly recommend you carry a very legal document on your person that states your intentions about life support.
I do not want to become a piece of jelly in a rolling chair.
Manuel D. Valencia III
What a bs. Personally im not looking forward to getting old. No pension, healthcare that is getting worse. I personally plan to tap out around 60/70ish. If the missus hasnt killed me by then that is.
Very funny!
kohakuebisu
It's hard to think of a more difficult subject, but medicine and nursing care have progressed to the stage where life can be extended beyond the point where there is still some quality or purpose to it.
This situation conflicts with the Hippocratic oath, so we need some kind of debate, especially as the global population ages and medical science only improves further.
I think I'll put aside the cost to two flights to Switzerland just in case.
John-San
When it comes to my daughter put in one of those hell hole I would reach for me euthanasia stash.
HonestDictator
This just reminded me of a 109 year old patient "living" in a nursing home. A pharmacist I was working with at the time showed me the patient profile, and the poor man should have been allowed to "move on" with the condition he was in.
Just a suggestion, but I think it would be a great idea to leave a video recording behind for our loved ones to be played on the day when we're expected to pass on and are unable to say something due to dementia/ brain death etc. Get the recording done while you still have the sense to be able to say what you want to.
That way, they'll have something to remember you by when you were still sane.
Novenachama
You may think that your genes determine your longevity but the truth is genetics accounts for a maximum thirty percent of your life expectancy. The rest comes from your behaviors, environment, and a little bit of luck. Also you may have heard about various life extension techniques but none of them have been proven in humans and most are just theories. In the end the only proven way to live longer is to live a healthy life.
albaleo
Which raises the question, "What constitutes a healthy life?" Do marathon runners live longer than smokers. Do vegetarians live longer than non-vegetarians? What about vegetarians versus those who eat fish but no meat? These things are far from proven.
If a healthy life is defined as one that makes us live longer, then isn't that begging the question?
Novenachama
albaleo:
Health is a complete state of mental, physical, and social well-being not merely the absence of disease but also managing a chronic disease successfully to minimize complication and recurrences. Healthy people are able to utilize whatever resources are available to them to live their lives on their own terms. In other words it's functional competence.
albaleo
I'm still confused.
Do you mean that people who "utilize whatever resources are available to them to live their lives on their own terms" are healthy. Or do you mean that only healthy people "are able to utilize whatever resources are available to them to live their lives on their own terms". I think there's a difference.
TakahiroDomingo
long life with love-family-health-wealth is great. short or long life without the good stuff is not good.
notagain
Quality of life is more important than the quantity.
Novenachama
albaleo:
For example: A paraplegic who goes to work every day supports their family and enjoys being alive is healthy. As far as the definition of resources, I mean all materials, personnel, facilities, funds, and anything else that can be used for providing health care and service. I hope this clarifies your question.
blocpartymuse
This issue was covered in detail in "Being Mortal" by Atul Gawande. An excellent read that I can highly recommend.
wanderlust
@blocpartymuse - have to second that. I bought multiple copies of 'Being Mortal' for my family members, to help them understand the issues and support the decisions which we had to make.
Homotenashi
Make sure she eats the food first.
kwatt
It seems that doctors would have to prolong patients life whatever as long as DNR is unacceptalbe in Japan.
wildwest
"Its better to burn out fast than to fade away." From some movie.
Ah_so
Actually, 60 years ago life expectancy at birth was about 80, they just did not realise it. Life expectancy estimations at the time were based on the life expectancy of those born in the 19th century.