Wednesday, May 12, 2010

A "Duty to Die"?

by Thomas Sowell

One of the many fashionable notions that have caught on among some of the intelligentsia is that old people have "a duty to die," rather than become a burden to others.

This is more than just an idea discussed around a seminar table. Already the government-run medical system in Britain is restricting what medications or treatments it will authorize for the elderly. Moreover, it seems almost certain that similar attempts to contain runaway costs will lead to similar policies when American medical care is taken over by the government.

Make no mistake about it, letting old people die is a lot cheaper than spending the kind of money required to keep them alive and well. If a government-run medical system is going to save any serious amount of money, it is almost certain to do so by sacrificing the elderly.

There was a time-- fortunately, now long past-- when some desperately poor societies had to abandon old people to their fate, because there was just not enough margin for everyone to survive. Sometimes the elderly themselves would simply go off from their family and community to face their fate alone.

But is that where we are today?

Talk about "a duty to die" made me think back to my early childhood in the South, during the Great Depression of the 1930s. One day, I was told that an older lady-- a relative of ours-- was going to come and stay with us for a while, and I was told how to be polite and considerate towards her.

She was called "Aunt Nance Ann," but I don't know what her official name was or what her actual biological relationship to us was. Aunt Nance Ann had no home of her own. But she moved around from relative to relative, not spending enough time in any one home to be a real burden.

At that time, we didn't have things like electricity or central heating or hot running water. But we had a roof over our heads and food on the table-- and Aunt Nance Ann was welcome to both.

Poor as we were, I never heard anybody say, or even intimate, that Aunt Nance Ann had "a duty to die."

I only began to hear that kind of talk decades later, from highly educated people in an affluent age, when even most families living below the official poverty level owned a car or truck and had air-conditioning.

It is today, in an age when homes have flat-panelled TVs, and most families eat in restaurants regularly or have pizzas and other meals delivered to their homes, that the elites-- rather than the masses-- have begun talking about "a duty to die."

Back in the days of Aunt Nance Ann, nobody in our family had ever gone to college. Indeed, none had gone beyond elementary school. Apparently you need a lot of expensive education, sometimes including courses on ethics, before you can start talking about "a duty to die."

Read the rest here.


  1. A family member of mine works in the pharmaceutical industry. He was talking to a senior VP at an HMO (name unknown) and asked why that HMO didn't authorize the use of a particular drug to fight a specific disease. The response was straightforward and to the point: "Because the lowest cost patients are the dead ones."

    Death panels are already in place; it is just a question of whether the US Government does it, the state does it, or a healthcare company does it.

  2. I first heard the odious phrase "a duty to die" from a former governor of Colorado in the 1980's (who I will leave nameless). There was a strong negative reaction from the public. At the time he was near the end of his "career" and didn't run for office again. The phrase dropped from public use and I didn't expect to hear it again. Sadly the politicians have legislated it back into use.

    Prof. Sowell is one of the greatest living economists in the world. He clearly has a passion for human life and his books reflect this. Thanks to RW for pointing his readers to this great article.

  3. Can Professor Sowell cite any actual living human who, in the last 10 years, has advocated a "duty to die"? I hear the soft sounds of straw men dancing.

  4. MikeBC, or should I say Mr. Strawman. Because the only way you could be hearing those "soft sounds" is if you are stuffed with straw yourself. In fact you must still be stuck on a pole in some corn field to have missed the fact that the federal congressman and senators recently passed a health care bill. Within the bill is a requirement that certain panels of "experts" be established to decide whose request for healthcare will be approved. Since this bill is now the law, those people receiving a "denial of claim" will have a duty to accept this decision along with its results. Even if the result is death. Everyone of the politicians that voted in favor of this bill are advocates of this duty.

    I realize these concepts are difficult to comprehend for a strawman such as yourself. And having been stuck on that pole out in the field for so long the wind has surely scattered your stuffing. And the "sounds of straw" blowing in the wind is no doubt distressing to you. But not to worry, I'm sure the new healthcare bill provides new straw.

  5. efinancial -

    you wrote: "Within the bill is a requirement that certain panels of "experts" be established to decide whose request for healthcare will be approved. Since this bill is now the law, those people receiving a "denial of claim" will have a duty to accept this decision along with its results. Even if the result is death. Everyone of the politicians that voted in favor of this bill are advocates of this duty."

    assuming you disapprove of what you have described, r u suggesting that unlimited resources be offered to any given individual in need of healthcare?

  6. YES to Anonymous...

    The key word in your question is "offered." Rather than the political duty forcing you to accept the choices of others about your healthcare, eliminate govt from the process and a free market will offer its unlimited healthcare resources to each and every individual so they can take advantage of as much as they choose to pay for.

    And affordability can be improved dramtically by eliminating govt's "mandate" to buy insurance or any other healthcare service. Allow competition in the healthcare industry and prices will be driven down just as they have been in products and services as diverse as electronics to shoeshines.

    People who try to impose the concept of a "duty to die" are simply trying to improve their own life at someone else's expense. The alternative is voluntary exchange to mutual benefit where each individual has the right to say no thanks. Or yes please I will pay for more.

  7. Like it or not, the problem won't be talked away due to several unreconciled factors.

    Factor 1. Medical progress in treatment of common diseases increased an average life span from the point of where people were happy to see their grandchildren, to the point where they think they are being denied their basic right to immortality.

    Factor 2. Longer life is not a longer youth; it’s a longer senility with progressing morbidity.

    Factor 3. The more extreme the treatment, the more it costs, exponentially. The more worn the body gets, the more extreme and costly are the treatments, the less their effect because – surprise surprise – all people are still mortal regardless of their opinion about it. Death is inevitable, and usually it doesn’t jump out but grinds people down slowly.

    So, put factors 1, 2 and 3 together and one simple question arises: what is the budget cap for cheating death? Or, how many sigmas are too many in a given situation? Answer that, and all the difficult (death panel) questions disappear. Don’t, and the price goes exponential, death wins not just one fading life, but many. It’s either one heart transplant with a sigh and a hope for the best, or numerous treatments of less dire conditions, with good outcomes. When that budget is not privately funded, some choice will be made – knowingly or otherwise.