Part of the aversion to thinking about death may not be the actual fact of dying but unease about the way we might die. In many ways we are fortunate that we live in a time when medical advances have enabled us to have much greater life expectancies than our ancestors. While much of this improvement has arisen because of reduced infant mortality, some has been because of our ability to combat many illnesses that once used to be quickly fatal. Because of the possibility of rapid response and treatment, many of the quick ways of dying such as due to heart attacks and strokes have been eliminated. But that improvement is not without its costs. We now see many more people having long and lingering deaths, the body and mind gradually losing functionality in ways that cannot be fixed, like an old car in which one part after another starts breaking down and one starts to wonder how much more one should invest in keeping it going.
My father died suddenly of a heart attack, his first, at the age of fifty-nine. It was a shock to all of us and by any actuarial measure he was far too young to die. But I knew my father. He hated and feared being sick and I suspect that he is like many of us, in that he would not have wanted to live to a ripe old age if the price that he had to pay was a long, lingering, and painful illness.
For example, I have given instructions that when I die, I want any organs to be used for transplants. I then want what remains to be cremated in the cheapest possible way. I watched an episode of the Penn and Teller Showtime TV series Bullshit! that dealt with death and was pleasantly surprised to learn that all you legally need as a container for cremation is a cardboard box that costs about $50.00 and this is what I want. The funeral industry tries to make the grieving survivors feel guilty if they go for cheap stuff and so people end up spending thousands of dollars on expensive caskets. What a waste! I will be dead. I won’t know or care how much money is spent on my death. The funeral industry is taking advantage of people’s fear that their friends will think they did not care for the dead person if they don’t splurge on a funeral. It is a scandal and I have left instructions to my family to not be played for suckers.
I have also given instructions that no extraordinary mechanisms should be used to keep me alive if the doctors feel that I have passed the point of no return. They should pull the plug with no regrets. Again, I have had a good life. It is not good to be greedy, to try and cling on and be a nuisance to the living.
The more difficult thing to deal with is a prolonged illness involving dementia. This can be very painful for the loved ones, to see someone who used to be alert and vibrant and independent reduced to a mere physical shell, a vegetative state where one cannot take care of even the most basic personal needs. The way to look at it is to realize that when that happens ‘I’ am already dead, although my bodily functions may still be continuing. By this I mean that ‘I’ am more than my basic physiology. I am also my mind. In fact, in my case, most of me is my mind and I see my body as merely the vehicle that allows my mind to function. So when my mind ceases to function in any way that is recognizable as me, then I am essentially dead because I have ceased to be.
The reason that people feel so bad at seeing someone they love in that state is that they think that deep inside is the ‘original’ person, the ‘real’ one, who is still the same and conscious of and frustrated by the disintegration of the external body. They think that the real person is saddened by the state of the physical one, that the real one feels frustrated with the physical one, and people are simply empathizing with that emotion. Other than in the rare cases of locked-in syndrome where one loses control of almost all muscles while the mind is unaffected, this idea of an inner person is really a religious idea, linked to that of the soul.
Of course, there is no reason to think that this is true. There is no real person inside. When my mind goes, I have also gone in every meaningful sense of the word. So do not feel sad for my state because there is nothing, no me, to empathize with. I have ceased to exist mentally and am simply waiting for the body to catch up with the death of my mind. This is why I think that assisted suicide should be made legal. I would like to take charge of my own death, so as to spare those around me the difficult decisions.
The desire to live is strong, though, and it is hard to predict if one is really willing to pull the plug on oneself until one is actually in that situation. You want people to make that decision when they are fully aware of what they are doing. But it is at those times that life is likely to be seen as still worth living. There are enough cases of people rationally making such a decision to suggest that there can be a time when the cost of continuing to live does not seem to be worth paying. But there are also cases of people who thought they would be willing to go quietly changing their minds and clinging on to life.
Ultimately it is an intensely personal decision and those who are not in that situation should refrain from judging the actions of those who are.