By Stan Walens
Almost 50 years ago, when today’s baby-boomers were still in elementary school, Jessica Mitford wrote "The American Way of Death," a stunning exposé of the ways in which funeral directors take advantage of family members during a time of intense grief following the death of a loved one. Mitford carefully dissected the many ways in which American culture avoids thinking about or dealing with emotional, practical and ethical issues of aging, illness, dying and grief, making us vulnerable to manipulation and coercion at the time when we are most vulnerable ourselves.
Those same baby-boomers are now aging into senior citizens themselves, and their immense numbers have had and will continue to have overwhelming effects on every aspect of American society, its economy and its healthcare system. The fact that such a large proportion of Americans are now coming to end-of-life situations, that so many people may need extremely expensive medical procedures to prolong their lives, that so many are retiring from economic productivity and yet will require immense resources to sustain them for years and even decades to come, raises questions that few people have been willing to address. Is it still possible to have as an overarching value the idea that everyone’s life should be prolonged to its greatest possible length? And how will we decide who should be kept alive longer, and who not: family members; doctors; health insurers; the government? Should tax dollars be used to keep a burgeoning population of senior citizens in prolonged medical care? Or should they, and ethically can taxes, be used to support physician-assisted suicide?
After centuries of avoiding these critical issues and thereby being trapped in the rituals and outdated practices of the past, Americans are now beginning to discuss and confront this essential life issue. Should life be merely a journey between two medically-controlled procedures — birth and flatlining — or should there be some kind of new, spiritual dimension to end-of-life care? But we cannot proceed blindly, as we have done in the past. It is time now to reconsider and refashion the American way of dying. Just what are our ingrained concepts of aging and dying, and what can we learn from the wisdom traditions of other eras and other cultures?
That is what lies at the center of Extension’s probing new course on Aging and Dying in American Society, taught by Katherine Irene Pettus. Dr. Pettus is a graduate of the Metta Institute, which advocates for reclaiming the soul in caregiving and restoring a life-affirming and transformative relationship to dying. Intimacy with death, and our beliefs about death and the mystery beyond, affect the way we live and die.
Dr. Pettus writes: More Americans than ever are aging into a healthcare system that is unprepared for them; many are caregivers for family members. We say we want to die at home surrounded by our loved ones, yet most of us die in institutions. How can we gain more control over our aging and dying? Sickness, old age and death are inevitable, yet our society hides them and avoids the most important conversations families can have. Learn about the economics, politics, ethics, medicine, spirituality, and art of aging and dying in the 21st century, about advance care planning, the debate over physician-assisted suicide, and the philosophy of palliative care. Through directed readings, film, art, poetry, site visits, and conversations with each other and with experts in the field, we will learn to craft a compassionate vision of this important time of our lives. (The class offers 27 hours of CEU credit as well as 3 units of Extension credit.)
Katherine Irene Pettus (Ph.D., Political Science, Columbia U.) is also a graduate of the Metta Institute for Spirituality in End of Life Care, and a long-time hospice volunteer. She has published a book on the American penal system, currently is writing a book on citizenship and palliative care, and is studying health law at UCSD and California Western School of Law.