AND ANOTHER THING
Victor Hugo's machine and the philosophical problems it raises
PAUL JOHNSON
Whenever possible nature should be allowed to take its course. This applies to the old as well as to everything else. Hospi- tals are not being cruel in wanting to get rid of patients for whom they can offer no treatment and who are simply occupying beds because they are decrepit.
We medicate and treat the aged too assiduously, keeping them alive, or half alive, against nature, often against their wishes. This is because society, being offi- cially Godless, treats death as the ultimate enemy; whereas to the Godly, death, like any other natural event in its due time and place, is a friend. The old should be allowed to die in dignity and meet death meekly when he comes in season. Three score years and ten is our lot, and we should be grateful if we enjoy them fully in reasonable health. Anything extra should be treated as a bonus.
No doubt the bonus can be worth having. I rejoice at the good fortune of the old lady of 92 whose poetry is about to be pub- lished, for the first time, by the Oxford Uni- versity Press. Recently, on a cruise up the Norwegian fjords, I made friends with another old lady, who celebrated her 85th birthday on board. I discovered we had similar views on a wide range of subjects, especially crime, punishment, dealing with hooligans, hanging etc. — amazing how sensible the very old are on these issues! And this week I have been celebrating the 100th birthday of a friend's mother who must be one of the few survivors — almost certainly the only woman — to have seen active service in the Great War. She lives happily alone and is a delight to her. friends.
There is indeed something satisfying about elderly prodigies who, unlike the infant variety, soothe rather than irritate one's feelings. Good luck to old Gladstone, for instance, for keeping the entire British empire in uproar over Home Rule when aged 84 — and to Marshal Radetzky, who is said to have fathered a child and invent- ed a new march when in his nineties. Far from being disgusted, one ought to be encouraged to hear of old men, or old women for that matter, disporting them- selves. When I lived in Paris in the early 1950s, an ancient man told me that, as a child of four or five, he had a vivid encounter with Victor Hugo, then over eighty. It took place in the early morning, before six in midsummer, in an old château, on the bare boards of the top corridor, where the children and maid-servants slept. The little boy, bored, had got out of bed to explore the castle and he met Hugo, in his nightshirt and bare feet, padding around in search of the sleeping quarters of a pretty housemaid, whom he had spotted at dinner the night before. The sunlight streamed in through the curtainless, cobwebby win- dows, making the bearded old rogue look like an Old Testament prophet transfig- ured. He seized hold of the little boy's hand, placed it on his triumphantly erect member, and said:
Tiens ca, mon petit — it parait que c'est tras rare a mon age! Mors! Tu aurais le droit dire a tes petits-enfants que to as tenu a la main le machin de Victor Hugo, poke!
The anecdote did not relate whether Hugo was rewarded for climbing up all those castle stairs. But one hopes so. Why? Because there is something splendid about the very old going down fighting — as Dylan Thomas put it, 'Old age should burn and rave at close of day.'
It is a different matter, however, for us officiously to strive to keep alive the frail, the bewildered, the imbecile and the help- less. Yet that is what, increasingly, we are doing. The financial cost will soon be crip- pling, when one in four will be over 65. The human cost is increasing even faster, as the lives of middle-aged children, especially women, are tied to the breathing corpses of their parents, kept in this world by a medi- cal profession whose philosophy has failed to keep pace with its technology.
I use the word 'philosophy' advisedly. Our growing ability to preserve people, even when they are in what is termed a per- sistent vegetative state, is forcing us to rein- vent medical ethics. Unfortunately, the sub- ject has been left largely in the hands of the doctors themselves, who are floundering, and lawyers with a forensic taste for ethics. To be sure, they are monitored by the the- ologians, especially the Jews and papists, who have strong views on the subject, I like and respect you. I just don't want to eat you.' which may well prove right in the end, but which ought to be subjected to the strictest scrutiny. What we lack is a thorough-going philosophical investigation of medical ethics, or rather a philosophical analysis on which a practical system of ethics can be built. But hardly any professional philoso- phers are working in the field. One of the few who does, Dr Sophie Botros of King's College, London, has been giving me tuto- rials on this topic and I am beginning to grasp the immensity and complexity of the problems.
These are real, life-and-death conun- drums, moreover, not the verbal parlour games played by most academics under the guide of philosophy. We have scarcely yet, for instance, subjected to philosophical analysis the ethics of using or cutting off life-support systems for incurables or those in PVS, one of the tricky areas in which Dr Botros is working. An agreed solution to the dilemma is becoming more urgent as our ability, for instance, to keep alive vic- tims of horrific road accidents increases.
Then there is the even more difficult problem of allocating funds to research into killer diseases. Should we, for instance, adopt a philosophical position of pure utili- tarianism, in which the greatest needs of the greatest number are, in numerical order, the criteria of priority? At present the matter is determined very largely by lobbying. That leads to anomalies, even scandals.
For instance, a huge and growing per- centage of available resources is being devoted to what many see as a fruitless search for an Aids cure. This looks like a classic case of throwing money at a prob- lem. Many would argue that such funds should go rather on methods of treating Parkinson's or motor-neurone or other horrific diseases, or forms of cancer or heart disease, both exceptionally fruitful fields of research. Others would add that, since the chief beneficiaries of an Aids cure would be promiscuous male homosexuals and drug-addicts, its priority for the general population is low anyway.
But all these points are, at present, sub- jected to rancorous and often abusive argu- ment, rather than cool philosophical inquiry. In the end we may find that the best solution is to allow the market, like nature, to take its course. But we ought to debate the issue first, properly, scientifically — and philosophically.
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