Recent studies indicate that the rate of the various types of dementia (inclusive of Alzheimer’s) afflicting the elderly are on the decrease. However, the US population is aging. When you combine this with increasing reliance on government funded healthcare throughout the populace, but particularly among the elderly, then you have to know that as a nation we are going to be facing numerous decisions about caring for the elderly with dementia – not just as individuals, but as a nation. To date such decisions are largely made as medical/healthcare decisions, but they have a deep moral component as they are based on the question of what constitutes personhood and our obligations to people whose personhood is in question.
The moral questions surrounding dementia care are heavily related to abortion. Given that most people consider the question of abortion “settled,” it is not surprising that people simply fail to note the ethical significance of how we care for the elderly with dementia. The slippery-slope is a very real thing and the road from abortion to euthanasia is far steeper and slippery than we might tend to think.
Most people when confronted with this issue simply shrug and start talking about advanced healthcare directives. While that deals with the legal issues, it says nothing whatsoever about the moral, ethical and theological considerations this condition presents us with. At the heart of this issue lies the fundamental moral questions that our nation confronts at this time. From defining the value of people on the basis of their cognitive abilities and usefulness to the simple question of self-image, dementia demands that we make our decisions on more than a medical and legal basis.
Advanced healthcare directives also frame these questions as highly individualized. That may be a great cop-out for a government increasingly devoid of moral consideration, but it is no answer for a church that claims moral authority. Yet in so many churches throughout the nation, when you approach for counsel that counsel consists of “think, read scripture and pray about it and complete this advanced healthcare directive form.” When it comes to making decision about a loved one the advice is usually, “Can I pray with you about this difficult decision?” Scripture reading and prayer are vital aspects of any Christian’s life, but the questions are so deep and important that the church must do the work to take a stand or else we risk what little moral authority we have left. Surely God has something to say to His church on these questions and not merely to each Christian individually.
Fortunately, there are theologians and other academics working on these questions. I am currently reading “Dementia: Living In The Memories of God.” I am only about one-third of the way through the book, but already I find it of immense value. When I have completed it I intend to review it thoroughly here. (Please do not expect that review soon – this topic is fraught with personal concerns and emotion for me and I must take the book in small chunks or risk serious emotional, and potentially legal, consequence.) It is an academic work of the highest order which is most useful as it supplies references to many other works in the field.
It also is a starting point. Buy a copy for your pastor – begin the discussion in your church. This presents a major ministry opportunity for any congregation, but it has far more significance and consequence than that. This is an opportunity for us to once again enter the public policy realm and regain the footing we have lost. I will not argue that the abortion battle is lost for current generations, but here is a new issue that centers on many of the same questions and offers us an opportunity to make many of the same arguments – hopefully better this time than in the abortion debates of the past.
Soon the government will be unable to avoid questions about what levels of care to provide to people as they become increasingly neurologically handicapped and I have no doubt that death-with-dignity and other near euthanistic arguments will be made. We must be prepared to push back and with God’s grace carry the day. This could be the last stand for the soul of the nation.