Demographics and the Medicalization of Human Existence

     “When man believed that happiness was dependent upon God, he killed for religious reasons. When he believed that happiness was dependent upon the form of government, he killed for political reasons….After dreams that were too long, true nightmares…we arrived at the present period of history. Man woke up, discovered that which we always knew, that happiness is dependent upon health, and began to kill for therapeutic reasons….It is medicine that has come to replace both religion and politics in our time.” – Adolfo Bioy Casares

     Quite a percentage of the most upsetting stories of the past few years have had a medical character. The execution by torture of Terri Schiavo, the government-decreed starvation of Leslie Burke, and Amy Richards’s murder of two of her three unborn triplets come to mind at once. The medical sector of society seems to have infiltrated parts of our media, and our consciousness, we once reserved for serial killers and horror writers.

     We needn’t stop there, of course. Just murmur “embryonic stem cell research” to yourself in a dimly lit room, and watch the shadows surge menacingly around you. Or perhaps “assisted suicide,” the “choice” whose proponents become more militant with each passing year. If you haven’t yet crept quivering under your desk, consider the “Groningen Protocol,” which multitudes of European and American physicians have enthusiastically endorsed. It would seem that the most venerated of the “helping professions” has grown bored with helping people to live, and has taken on a sideline of a quite different sort.

     Why are physicians helping to stoke the engines of death, and why are we allowing them to do so?

     If you haven’t asked yourself that question yet, check your pulse: you may have died and not noticed. Of course, in that case the subject would seem a deal less relevant, but your Curmudgeon will proceed nevertheless.


     Immediately after World War II, the massed armies of the combatants pretty much dropped their guns where they stood and flocked home to procreate. In the United States, the population surge this produced is well known as the Baby Boom, and its individual members as Boomers. Though the phrase is American, the other nations that were heavily involved in the war all experienced similar demographic spikes, as fighting men all over the world remembered that there was an activity they greatly preferred to taking orders and dodging bullets.

     For at least forty years, the worldwide Baby Boom has been the demographic fact of greatest significance to the nations it affected. It’s pulled politics, economics, technology and culture into its wake; the desires of so great and concentrated a mass could hardly do otherwise. But its influence on the attitudes and practices of the medical field, and the interplay of medical with political trends, have been less well analyzed than they deserve.

     The influence of the vast Baby Boom market on the commercial sector has been plain to see. Whatever Boomers wanted, or were imagined to want, industry strained to produce. By and large, that hasn’t been a bad thing. But today, with the Boomer cohort trudging toward late middle age and peering forward at seniority, what Boomers want is quite different from what we wanted twenty years ago.

     Basically, we want to be young again. Functionally young, not calendrically. We want to look young, feel young, enjoy the pleasures and opportunities of youth, and — here’s the kicker — evade the burdens and responsibilities of age. Of course, many an oldster before the Boom has wished for his youth back, for the above reasons and others. But never before in recorded history has a demographic cohort this large wished for that benison this ardently, and been as pandered to as ours is being.

     When we were young, we were treated like royalty. We were catered to as children, given few or no responsibilities and whatever pleasures or diversions we wished. We were made into the center of the universe as teenagers and young adults, told that our half-assed opinions mattered despite our callowness and ignorance, and flattered by legions of politicians and media barons. As we moved into middle age, we were handed the reins of government and industry without a fight, and largely without having to prove our mettle. Bliss it was in that dawn to be alive, but to be a Boomer was very heaven.

     It was a natural consequence of the postwar years. The wars had reaped tens of millions of lives; disease had ravaged tens of millions more. Our parents, weary with conflict and destruction, looked to us to improve on their record…in a sense, to save the world not only for them but from them. Wishful thinking? Yes, of course…yet on what grounds could a youngster of our day assert that he’d have been immune to the temptation? Since the Industrial Revolution, no generation had been tested as severely as the parents of the Baby Boom. It might be dozens of centuries before men face such trials again.

     But understanding it is insufficient to avert its consequences. Boomers are a youth-fixated people. As we move ever deeper into the latter halves of our lives, our desire to avert the consequences of that transition becomes ever more powerful. We devote increasing amounts of time, money, and effort to preserving the things of youth. We’ll even take the form if we can’t have the content; witness the explosive growth of the cosmetic surgery industry.

     The implications for the medical field, including the critical field of medical research, would seem to be clear. Some of them, at least:

  • We want to look and feel young.
  • We want to be treated the way we were when we were calendrically young.
  • We don’t want to become infirm.
  • We certainly don’t want to die.

     Science fiction author Larry Niven, in a series of stories in his “Known Space” canon, narrated some of the more horrifying sociopolitical consequences of a youth-fixated / death-averse world. If the vote could be used to stay young and hale, he reasoned, it would be. Therefore, given the chance, citizens would vote for the death penalty for every imaginable offense, and mandate that the sentence be carried out in an operating room. The condemned would be transformed into transplant resources, to help keep the law-abiding folks alive and well.

     We’re not at that point yet, but we’re getting closer. Embryonic stem-cell research is not morally distant from Niven’s premise. A few nations have considered passing mandatory organ donation laws. A few folks have even suggested that executing a condemned man and throwing away his body is simply wrong, when his organs could help to compensate for the harm he’d done in life.

     If such nightmares poke their snouts into the light of day, it will be because Boomers have demanded them.

     But Niven’s speculation is far from the end of the subject. Young persons, healthy and vigorous, seldom need health care, and therefore seldom need to pay for it. The older they get, the larger this burden becomes financially. Medicare and Medicaid, along with the pervasive practice of paying for any and every kind of medical service through insurance, have greatly accelerated those costs, per office visit, per lab test, per treatment, and per capita.

     A Boomer today not only faces medical bills far greater than his parents did at his age, but the treatments and services he buys are much more desirable to him: less painful, more likely to work without undesirable side effects, and more oriented toward maintaining him in a condition of fitness and vigor. To his parents, medicine and its practitioners were a recourse in times of great need, invoked only to cope with serious conditions and life-threatening injuries. To him, “health care” is the Fountain of Youth.

     If you’ve never understood how a nation with so many horrifying examples of the failures of socialized medicine before its eyes could nevertheless flirt with allowing Washington to nationalize the health care industry, perhaps you understand it now.


     The above certainly has explanatory power for much of the medicalization of human existence. But there’s another, darker facet to Boomer culture that remains to be critically examined: how Boomers’ desire to remain young and hale feeds the engines of death.

     That’s really part of the “positive” side of the equation: the part that hopes that by sacrificing the most defenseless proto-humans of all, we might contrive to extend our own health and vitality. To grasp the negative side of things, we must study financial factors more deeply.

     A dollar spent on X is unavailable to be spent on Y; this is the monetary corollary to the Principle of Scarcity on which all of economics is based. He who projects that his own bills will be rising sharply, for whatever reason, will certainly feel a desire to minimize the expenditures others “force” upon him. If he foresees great increases in those involuntary expenditures upon others, that would force him to reduce his expenditures upon his personal needs and desires, he will be greatly distressed. He might toy with “doing something about it.”

     Thus, we enter the realm of euthanasia.

     A mere three generations ago, the suggestion that Gramps be “put to sleep” for any reason, much less to free his kids of the bills for his maintenance, would have been greeted with an outrage that transcended horror. Today it’s an active topic of discussion. Several states have submitted to the demands of such groups as the Hemlock Society by enacting “assisted suicide” laws. From time to time, public figures have made comments about the “duty” of the old to “get out of the way” of the young. “Ethicist” Peter Singer, a hero to many for his arguments in favor of retroactive abortion, argues that below a certain “quality of life,” a creature no longer possesses a right to life, and can be put involuntarily to death for utilitarian reasons — an assertion that reaches every point on the spectrum of age. The doctors who authored the Groningen Protocol have employed this argument, too.

     Boomers grant the discussibility of euthanasia for the lowest of all reasons: it would save us money. We’d no longer have to worry about how to foot the bills for Gramps, or for the spouse with terminal multiple sclerosis, or for the child with severe cerebral palsy or Down’s Syndrome. Beyond the money, it would save us having to labor over those wretches, or endure their complaints and their lack of gratitude. Away with them! If the State won’t take them off our hands, maybe God will! More time and money for us, that’s the ticket!

     Of course, we hedge our selfishness and cowardice with the nicest of stringencies. There must be consultations and deliberations. Family, physicians, psychiatrists, bureaucrats — everyone must have a say. There must be nothing that could possibly be done for the sufferer to elevate his “quality of life” near to that of an actual person. And of course, when we inevitably decide upon the inevitable Quietus, it must be painless — not for the sake of the guest of honor, but as a balm for our own consciences.

     And the “medical community,” power and wealth in prospect, rushes to comply. Hippocratic Oath be damned; that might have been good enough for the pagan Greeks, but we’re beyond all that now. We’re civilized.

     Are we?



     As a rule Boomers are not good about bearing pain or helplessness. Of course, that’s one of the drivers of the New Medicine; never before have there been so many different analgesics and therapies for pain, and so many artifices to help a disabled person cope with the challenges of life. But ultimately, all these things must fail; no one’s body can be kept sound forever. He who is unlucky enough to outlive his health and strength must either accept increasing discomfort and the loss of his abilities, or die.

     Because we’ve known so little pain and disability, a good many of us want to make certain that we’ll have “assistance” toward the Final Exit when the time comes. It’s a form of cowardice that earlier generations resisted far better than we…but then, a member of the pre-Boomer generations bore more pain in his first ten years of life than a typical Boomer will know lifelong.

     Few Boomers who call vociferously for “assisted suicide” laws pause to think about the pressures our progeny might put upon us to “use” those laws…possibly well before the thought ever enters our heads.


     The medicalization of our existence is being driven by our existence itself: our privileged position in space, time, and circumstance as the least burdened, most pampered people ever to slide behind the wheel of a Lexus. Life is good; we want to keep it that way, especially those of us from the have-it-all Boomer generation who’ve hardly known privation or suffering. If the promises become lurid enough, we might well succumb to the lure of bureacratized doctors as unreviewable arbiters of life and death — and don’t kid yourself; socialized medicine, for which “universal health care” is a mere circumlocution, means exactly that.

     Think, and pray.