If you’re useful, you can live

But the elderly really have a tough time getting approved by the arbiters of life and death medical decisions. Especially since many more Americans are living longer.

According to the Census Bureau, there were 90,422 centenarians in America in June, up from 50,454 in 2000, and demographers project there could be 1.1 million by 2050. As for 104-year-olds, the Social Security Administration said that 2,114 of them currently receive benefits.

With such rapid growth of centenarians, debate has mounted over how far to go — not to mention how much Medicare money to spend — in providing major medical services to extend already very long lives.

Read the top of that Times article. It’s a snapshot of just one medical ethics debate brewing in this country.

When Hazel Homer was 99, more than one doctor advised that there was little to be done about her failing heart except wait for it to fail a final time. But Mrs. Homer was not interested in waiting to die of what many would call old age.

Now, at 104, her heart is still ticking, thanks to a specialized pacemaker and defibrillator that synchronizes her heartbeat and can administer a slight shock to revive her if her heart falters.

Her operation, a month before her 100th birthday, reflects what some doctors are hailing as a new frontier in medicine: successful surgery for centenarians. But others say that such aggressive treatment for what are euphemistically known as the late elderly can be wasteful and barbaric, warning that the rush to test the limits of technology can give patients false hope and compound their health challenges with surgical complications.

As my nurse/bioethicist friend Nancy Valko said, in passing along this Times article: “As predicted, your so-called “right to die” can easily become your duty to die by denial (or withdrawal of care) if “experts” decide you are too old or too impaired and thus a drain on society. Some choice!

Reminded me of this article I saw not long ago. In case of disaster or pandemic…

The gut-wrenching dilemma will be deciding who to let die.

And the real disturbing problem right now is that some people in health care already are.

Beware! What we don’t condemn, what we claim to be mere “dilemmas,” we eventually are urged to allow. Infanticide is moving into the mainstream of bioethics and the medical intelligentsia.