Death
Panels in Perspective
©
Charles D. Hayes
As a longtime resident of Wasilla, Alaska, I
wonder if my hometown will ever escape its current association with
partisan politics in the minds of people elsewhere. More
specifically, will the American public ever be able to engage in an
adult conversation about end-of-life medical issues? Too many
people, it seems, don’t realize that death is bipartisan. In the
recent public town-hall meetings about reforming health care, efforts
to provide end-of-life counseling have been described as “death
panels,” most notably by one of our prominent Wasilla citizens. Such
language is a blatant example of demagoguery.
In 1974, Ernest Becker won a Pulitzer Prize
for The Denial of Death, a book about a formerly taboo
subject. It was a prescient work that has become a perennial best
seller. Becker agreed with philosophers of the past who have argued
that human beings can only stand so much reality and that a total
apprehension of the precariousness of our lives would drive us
insane.
He understood that until we face up to death,
maturity is impossible and wrote in detail about the extraordinary
effort we make to avoid facing our own mortality. Becker was also
very much aware of the irony involved in the conundrum that one of
our deepest needs is to be free of apprehension about death and yet
we experience this most acutely when we are feeling fully alive.
In the decades since Becker’s own death, a new
school of psychology known as "terror management theory" has gained
momentum, arguing that any and all reminders of death have a
negative effect on our judgment. In my forthcoming book,
September University: Summoning Passion for an Unfinished Life,
I discuss at length how the fear of death, coupled with intolerance
for otherness and a lack of curiosity, causes us so
much anxiety that it forever detracts from our ability to enjoy life
free of the need to blame others for life’s difficulties. The mere
mention of a word, metaphor, symbol, or example that reminds us of
dying has been shown to negatively influence our decisions.
In politics this works magically because
psychological studies show that we often respond to fearful
reminders about death with an aggressive attempt to defend our
political views. So, when a few misguided cheerleaders disparage the
need to provide medical counseling in the final stages of life,
emotion overrides our ability to reason and everyone loses.
Nowhere is it more important to set aside
partisan politics than when discussing the end of life because we
are all going to die—for most of us sooner than we think. In
politics, in particular, we identify with our political party, and
when our side loses an election we suffer a loss of stature that
bears a conscious or subconscious association with thoughts of
death. In other words, we die a little. And if you fear the future
and revere the past, here again, as the terror management
psychologists frequently demonstrate, change and uncertainty become
interchangeable with feelings that the end is near. Fear mongering
about end-of-life medical issues can win a political argument by
controlling the opposition’s fear, but when this happens, the stakes
are such that the terminally ill lose the ability to die with
dignity.
To show his contempt for the demagoguery of
calling medical counseling death panels, editor Jon Meacham, in the
September 21, 2009, issue of Newsweek, declared that he had
been a teenage death panelist and has in fact served on two such
panels, one for his grandfather and one for his father. He says, “One
answer to the health-care conundrum is painful but inescapable: we
have to become more comfortable with death.” I have served on five
such panels with my family, and I know without a shadow of doubt
that things worse than death can happen to people. My maternal
grandparents went through years of barely conscious but visibly
obvious medical torment and excruciating pain. Death in the 1980s
was a subject to be avoided, and there was no counseling available
for family members or mature guidance for them in realizing that
there are experiences more horrific than death.
The rugged beauty of the Alaska wilderness
offers frequent reminders about the harshness of reality. I often
wonder what it would be like if our migrating caribou were
consciously aware that someday, with a high degree of certainty,
each of them individually will come face-to-face with the wolf. I
think about this because we humans share a similar fate. But instead
of the wolf, we face the nursing home. And, speaking from my own
experience, I prefer the beast.
In
Nasty, Brutish, and Long,
psychologist Ira Rosofsky writes with profound seriousness, but also
with humor and compassion, about his years of experience in dealing
with patients in nursing homes. He tells us that if we reach age 65,
we have a 43 percent chance of winding up in a nursing home, and if
we reach age 85 our chances for dementia are one in two. Further,
the average nursing home resident ingests about 10 drugs per day. In
an example that speaks as loud as any about the lack of humanity in
our health care system, he characterizes the situation with what he
calls the “Rosofsky Law of Inverse Proportionality: The more
training you have, the less time you spend with patients.”
Rosofsky reminds us that the average person
aged 65 to 74 has about seven hours per day of leisure time (maybe
less with today’s economy), an observation that reminds me of one of
my reasons for writing September University. Those of us
with more than a half-century of life experience should have the
maturity and, one would hope, the will to see that end-of-life issues
are discussed without resorting to petty politics. Those of us with
experience visiting friends and family in nursing homes know that in
some cases people do better in nursing homes than they would living
alone, but that being in a nursing home and being lost in the
corridors of your own mind is a dreadful fate. Who among us would
prefer that, instead of death with dignity, we be shot full of
stupor-inducing chemicals, quietly managed by as few staff as
possible, and end up being warehoused in order to keep the Medicare
payments going? Of course, if we are drugged into mental oblivion,
we would not likely care, except you have to wonder what goes on
behind those desperate looks from the many nursing home residents
who can’t seem to bring themselves to speak a complete sentence, but
who are obviously experiencing what Rosofsky refers to as
unfocused rage.
So the next time you hear someone step up to
the podium and try to misrepresent health-care reform by making the
public fearful of impending government death panels, please ask the
speaker to stop the fear mongering or please be seated and let
someone else have a word.
Jack London, the writer that drew me
to Alaska and who died young, said he would rather be “ashes
than dust.” I, myself, would prefer a death with dignity to what
Rosofsky depicts as nasty, brutish, and long. How about
you?
September University:
Summoning Passion for an Unfinished Life
is available for preorder on Amazon.com at a 33 percent
discount
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A Teachable Moment: Police
Authority and Racism
©
Charles D. Hayes
As an ex-police officer, I have a unique perspective about
the subject of police authority and racism, especially after having
distanced myself from the profession with an aggressive thirty-year history
of studying the antics of human behavior. One of the things that psychology
has made clear about primates and humans is that males in positions of power
experience a rise in testosterone. Put a low-level male in charge of a
group, and in time he will blossom into an alpha male with the appropriate
level of hormones for the job. This also applies to females, perhaps to a
lesser degree. Put a badge and gun on a man or a woman, and in time a bold
persona becomes part of a law officer’s personality. It begins to feel
right, and it defaults to overt assertiveness when one’s official authority
reaches into gray areas.
I know from experience that taking on the persona of a
law-enforcement officer results in a surge of internalized boldness; it’s
just part of the job. At times this is a necessity because police officers
often find themselves in situations where a high degree of assertiveness is
all that stands between them and losing control of a situation. I also know
from personal experience that if police officers are not constantly reminded
of the dangers of crossing the line through their use of their authority,
then abuse of their power is a virtual certainty. Further, as with any
minority (and police are a minority), associates tend to stick together.
That police will back up one another, even when their fellow officers are
wrong, is as dependable as sunrise.
For a teachable moment to occur out of the recent incident
with a Cambridge police sergeant and a distinguished university professor it
would be necessary to reenact the incident, to do a play-by-play enactment
of everything said, of every gesture made, and of the voice inflection and
tone of everyone involved, and then to read the laws covering this situation
very carefully. It would be an extraordinary learning experience for
everyone who participated. From what I’ve learned of the incident, and based
on my own experience, I don’t believe Professor Henry Gates broke the law.
What occurred, in my view, is that a learned scholar embarrassed a police
sergeant in front of his subordinates, and the sergeant overplayed his hand
and authority in the same manner that occurs all over the United States day
in and day out. The default position in this case is aggravated by the
sergeant’s need to maintain the respect of his subordinates. Moreover, the
reason I am quite certain that Professor Gates broke no law is that the
police department dropped the case immediately. There was no case, and you
can rest assured they wouldn’t have dropped it if there had been one.
In the 1960s I was guilty of this same kind of behavior as a
police officer in Dallas, Texas. I am not now in any manner antipolice
simply because I am no longer in law enforcement, but I am very much aware
of how easy it is for officers with honorable intentions to cross the line
and abuse their power. It is an occupational hazard that needs to be
acknowledged as such and guarded against by police department managers to
keep it from bringing harm to both the police and the public.
Race was an underlying issue in the Cambridge incident, as
the African-American professor was very likely oversensitive (but not
without some justification) and perhaps overly defensive, but I believe a
reenactment would prove beyond doubt that he broke no law. He was guilty of
disrespect for a person who performs a dangerous and often thankless job
that someone has to do.
For anyone of any race or nationality to declare themselves
not a racist is a gross oversimplification. Just as we are all capable of
both good and evil, we all have a built-in bias—a primeval, our kind
bias—that exists as a matter of degree and can be made to surface, given the
right context. Through psychology we have known this about ourselves for
many years, and the fact that we have achieved so little public
understanding, especially on the part of peace officers, is deeply
disappointing. I discuss the topic of us and them in great
detail in my forthcoming book, September University: Summoning Passion
for an Unfinished Life. There I show how we are bedeviled by this
issue all of our lives, especially if we remain unaware.
President Obama was right the first time when he said the
police acted stupidly, because they should know better. It’s unfortunate
that the president found it necessary to step back and retract the remark
because until we can see this kind of action with some objectivity, we will
never learn enough to actually be objective in such matters. I don’t doubt
the police sergeant is a good man, but I very much doubt his objectivity.
His authority went to his head to save face, and he overrode the law he was
supposed to uphold.
Yes, I’ve been there, done that. And since then, it’s taken
an extraordinary amount of study and reflection on my part to realize that
in many cases I used to act inappropriately, sincerely believing at the time
it was my job to do so.
|
View the cover of
September University:
Summoning Passion for an Unfinished
Life
January
2010 (pre-orders are available Amazon.com). |