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Just came across a thought-provoking article in the Guardian about doctors foregoing treatment when diagnosed as terminally ill, largely because they have so often witnessed the poor quality of life of those undergoing treatment to extend their lives for a short period.

This issue came to public attention due to an essay by American doctor, Ken Murray, who made a strong case for terminally ill patients opting to eschew invasive life-prolonging treatment and choosing to die at home.

I have very little personal experience of these difficult issues, so I hesitate to comment, but it did make me think of three things.

1) The word 'hypocrisy' came to my mind, but at the same time I felt invaded by a cultural meme. You hear this word so much these days, and it spoken with such rhetorical force, but even a tiny bit of human insight tells you that we are all hypocrites to a greater or lesser degree. For all of us there is a gap between what we think and value, and what we do.

2) Relatedly, we often believe one thing in one context, that appears incompatible with what we believe in another context, without stopping to wonder whether it is(or indeed perhaps should be) the context, rather than our sense of agency that is the biggest determinant of what we believe and do. This pervasive feature of human experience is sometimes called cognitive polyphasia.

We might think we would not want to prolong our lives with invasive treatment in abstract, or even as professionals, but it doesn't follow that we would think the same thing if our own life was at stake. There is a famous quotation( I forget the source) that says something to the effect that life and consciousness are so valuable that even if our lives involved being alone and holding tenaciously to a rock in the middle of the ocean, this would be preferable to death. I don't know about that...but it's not really for me, now, to say.

3) The best book I read on related issues was Grace and Grit by Ken Wilber, about the five years just after his marriage in which his wife had breast cancer and eventually died. It was a poignant and absorbing read, peppered with spiritual and philosophical insight. For instance:

And that is exactly what Treya was doing. If and when death came, she would deal with it then, not now.

There's a great Zen koan on this. A student comes to a Zen Master and asks, 'What happens to us after death?' And the Zen Master says, 'I don't know.'

The student is aghast. 'You don't know?! You're a Zen Master!'

'Yes, but not a dead one."



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