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I don't think it's so much that we kill people. It's that we let them die. If we are truly, brutally honest with ourselves (and overcoming denial, social, relig

I don't think it's so much that we kill people. It's that we let them die. If we are truly, brutally honest with ourselves (and overcoming denial, social, religious, whatever conditioning here is a huge struggle), much of the time, the efforts we put in to keeping loved ones alive is really often more about us than it is about them. The elderly (and I'm generalizing, I realize) are far more accepting of death. It's easier to accept that when you feel you have lived a full and happy life. Contrarily, that full and happy life often involves having the presence of loved ones, who are NOT ready to accept that their life will be - or rather, will feel - less full and happy without that person. Even just simple denial is a huge thing. One of my first experiences in emergency medicine was an older gentleman, family patriarch. The rest of his extended family had been able to gather at the hospital while he was in and out of arrest. A provider and support person went to talk to the extended family, who was adamant about following his son, the 'number two patriarch', and his steadfast insistence, "He is a good strong Christian man, and he is going to be okay." (I say this not to mock Christians, to be clear, and also to be clear, he didn't mean in the "eternal life" sense, he and the family truly believed almost that divine intervention was going to take care of things). After some discussion on this, a decision was made to bring the son into the ER where we were working on his father. Seeing the hopelessness and futility, seeing his father the shadow of the man he knew, and all of that assorted detail was no doubt traumatic, but it also made it viscerally real to his son. No matter the concerted efforts of nearly 10 medical professionals, drugs, defibrillation, ventilation, we were not going to be able to keep his father alive, and there was not going to be any divine intervention. He watched this silently for a few moments, and then asked us to discontinue CPR and if his father's organs were suitable for donation. My heart broke for him. But this is a struggle we have not figured out, recently. We had it figured out, historically, by necessity, but we are complacent now. Leaving aside the separate issue of healthcare costs, you can still look at the ratios: In the US, on average we spend more on healthcare keeping someone alive for the last year of their life than we do on the previous decade. And we spend more on that decade than we do on the rest of their life. Some of which seems obvious, given youth, but nonetheless.

feoren 3y ago
It's a powerful story, but it's simply not relevant to my argument, and I suspect the reason you think it is relevant is because you've deeply internalized the inevitability of death. Of course you, and we all, have: it's been inevitable for the entirety of human existence. But humans were never able to fly across the ocean for the vast majority of our existence either, nor were we able to orbit the Earth or communicate at near light speed with the other side of the Earth. People who say death is inevitable are putting it in a special category: it's the one thing humanity will never be able to solve with technology? We can colonize other planets, split the atom, develop computers and AI, but keeping oxygen flowing to the cells is just forever beyond our reach? No. Your story is about a man's denial that his father, currently in critical condition, would die. Yes, the probability that humanity would solve death in the hour of life his father had remaining was low. I'm talking about humanity's denial that death is just a giant bag of problems that we can, eventually, solve one by one. The probability that humanity will solve death in the next thousand years is nearly 100%; the probability that it will be solved in our lifetimes may be low, but it's not 0. (Keep in mind, 1000 years is ten times the lifespan of an exponentially accelerating medical field, not simply 1% of the whole human history in which basically no progress was made.) If we had a simple, maintainable, cheap machine that could keep people alive for 100 years without a working heart or lungs, there is no ethical dilemma, and the line between "killing them" and "letting them die" becomes pretty blurry. The reason this matters is that once we actually start to realize that death is a problem that we can actually solve, then we can get the fuck to work on it! We could be investing so much more than we are in treatments like ECMO. There should be a national moon-landing-level initiative to make these machines available to everyone. But the longer we mope around with our learned helplessness, calling people like me naive and in denial, the more people will die needlessly.
- FireBeyond 3y ago
  Then going to your point, there are many discussions around theoretical upper bounds for human life, even factoring in technology. Studies look at blood cells and footsteps and establishing hard limits. One of the more recent ones suggests around 150 (today it's around 120). > with things that usually kill us omitted, our body's capacity to restore equilibrium to its myriad structural and metabolic systems after disruptions still fades with time. And even if we make it through life with few stressors, this incremental decline sets the maximum life span for humans at somewhere between 120 and 150 years. In the end, if the obvious hazards do not take our lives, this fundamental loss of resilience will do so. https://www.scientificamerican.com/article/humans-could-live-up-to-150-years-new-research-suggests/ https://www.scientificamerican.com/article/humans-could-live...

feoren 3y ago

It's a powerful story, but it's simply not relevant to my argument, and I suspect the reason you think it is relevant is because you've deeply internalized the inevitability of death. Of course you, and we all, have: it's been inevitable for the entirety of human existence. But humans were never able to fly across the ocean for the vast majority of our existence either, nor were we able to orbit the Earth or communicate at near light speed with the other side of the Earth. People who say death is inevitable are putting it in a special category: it's the one thing humanity will never be able to solve with technology? We can colonize other planets, split the atom, develop computers and AI, but keeping oxygen flowing to the cells is just forever beyond our reach? No. Your story is about a man's denial that his father, currently in critical condition, would die. Yes, the probability that humanity would solve death in the hour of life his father had remaining was low. I'm talking about humanity's denial that death is just a giant bag of problems that we can, eventually, solve one by one. The probability that humanity will solve death in the next thousand years is nearly 100%; the probability that it will be solved in our lifetimes may be low, but it's not 0. (Keep in mind, 1000 years is ten times the lifespan of an exponentially accelerating medical field, not simply 1% of the whole human history in which basically no progress was made.) If we had a simple, maintainable, cheap machine that could keep people alive for 100 years without a working heart or lungs, there is no ethical dilemma, and the line between "killing them" and "letting them die" becomes pretty blurry. The reason this matters is that once we actually start to realize that death is a problem that we can actually solve, then we can get the fuck to work on it! We could be investing so much more than we are in treatments like ECMO. There should be a national moon-landing-level initiative to make these machines available to everyone. But the longer we mope around with our learned helplessness, calling people like me naive and in denial, the more people will die needlessly.

FireBeyond 3y ago
Then going to your point, there are many discussions around theoretical upper bounds for human life, even factoring in technology. Studies look at blood cells and footsteps and establishing hard limits. One of the more recent ones suggests around 150 (today it's around 120). > with things that usually kill us omitted, our body's capacity to restore equilibrium to its myriad structural and metabolic systems after disruptions still fades with time. And even if we make it through life with few stressors, this incremental decline sets the maximum life span for humans at somewhere between 120 and 150 years. In the end, if the obvious hazards do not take our lives, this fundamental loss of resilience will do so. https://www.scientificamerican.com/article/humans-could-live-up-to-150-years-new-research-suggests/ https://www.scientificamerican.com/article/humans-could-live...