By GEORGE A. KENDALL
The Fourth Commandment is central to the order of every society, because the continuity of life from generation to generation is central — how younger generations deal with older ones, how the young treat the old, is crucial.
I like to think of the Fourth Commandment as the binding of the book which is the Decalogue. The first three Commandments have to do with our relationship with God; the last six with our relationship to our neighbor. The fourth ties together piety toward God with piety toward our past, toward our origins, which binds together the social order in all of time, including the present, and hence concerns our relationship to our neighbor. If we don’t respect the past and don’t respect our ancestors, we are certainly not going to respect either God or neighbor, and the whole Decalogue goes down the tubes.
So, when it comes to the relationship of the generations, how are we doing? Not very well.
First of all, there is a demographic problem, one resulting largely from bad human choices. After World War II, men came back from the war eager to make up for lost time, especially when it came to starting families. Many had large families, as a result. Having suffered through both the war and the Depression, they were anxious to give their children all the things they had gone without and went overboard, spoiling the little brats rotten. The result was a new and very large generation of self-centered people who, unlike their parents, had very small families, not being willing to sacrifice for the next generation.
Now that that generation is getting old, how to care for them in old age has become a huge problem, because care has to be provided by younger generations, who are far less numerous than their predecessors. That means there are not enough younger people working and paying taxes to cover Medicare, Medicaid, and Social Security.
But the problem is not just money; it is people. In nursing homes, for instance, you need nurses and nurse’s aides to provide care to the elderly, and we are already getting to the point where there are not enough of them. So the ones who are available are often expected to work double shifts — something that can lead to their being chronically exhausted, with a high risk of their making dangerous mistakes. The result is that many people will not take these jobs, and many others, after working at them for a while, decide to quit. This leads to high turnover and a loss of continuity of care. It also means that a very high percentage of workers at any given time are inexperienced. It is a vicious circle.
A very large number of the elderly now end up in nursing homes, because more and more of them become old enough and sick enough to need 24-hour care, which often is not feasible in the home, a problem aggravated by the small size of most families today and the fact that both spouses generally work outside the home. The cost of long-term nursing care is so high that people who are not wealthy are not able to pay for it. That part of the problem is being dealt with at this time through Medicaid. The overwhelming cost of nursing care is such that it needs to be financed collectively rather than by individuals or families. The way Medicaid works is that you pay for your own care until your money runs out, then Medicaid kicks in. At this point, any income you have goes to the cost of your care, except for a small amount you get to keep for personal expenses.
Basically, the system requires people to pauperize themselves in order to get the care they need in old age. This has its biggest impact on the middle class, since the poor are already paupers (by definition), and the rich can pay their own way. I would argue that the requirement that the elderly pauperize themselves is an attack on human dignity and thus, applied to the elderly, is a fundamental violation of the Fourth Commandment. It is demeaning and disrespectful to the elderly (and hence fails to honor them), and it comes close to making them non-citizens, non-persons who have been sidelined and forgotten by the rest of the world — not honored and respected elders. This substantially weakens the psychological barriers which, if in place, would prevent people from neglecting or abusing them. It makes them vulnerable. The relationship between the generations is definitely distorted in this situation. And it is almost certain to get worse.
The math of the situation indicates that before long there will be a general recognition that we have a huge problem with large numbers of old people and not enough money to support them in or out of a nursing home and with an insufficient number of people to care for them.
One obvious answer to the first problem is to raise taxes to cover the costs of elder care, but devoting funds to this purpose is something that becomes less popular the more self-absorbed people become.
An answer to the second problem would be to bring in immigrants to provide care. But the widespread anti-immigrant sentiment in our country today, along with the other accompanying problems, would make this difficult. It would require a certain amount of wisdom on the part of our leaders, a commodity not much in evidence among members of that class.
I am afraid that another answer might tempt us. While the demographic situation unfolds, respect for the sanctity of human life is in rapid decline, as is evidenced by the increasing acceptance of euthanasia, justified, in many people’s minds, as “mercy.”
It is already legal in a number of states, and it is probably only a matter of time until it is legal throughout the nation. Once that happens and euthanasia becomes widely accepted, it is likely to become commonplace. It would be much cheaper than the other possible solutions, and it would avoid the social problems that might be attendant on bringing in large numbers of immigrants to care for the elderly, let alone the political problems involved with tax increases.
The obvious way to carry it out, at least at first, would not be to directly force euthanasia on people, but for programs like Medicare and Medicaid to simply adopt a policy that they will no longer pay for nursing care but will be happy to pay for lethal injections, at least for those persons whose lives the bureaucrats judge not to be worth living (but maybe later for everyone). The advantage to this is that if we put people out on the curb in their wheelchairs and leave them to die, the whole thing happens in plain sight and would no doubt upset many. This way it would be kept out of sight — Hitler’s strategy.
Also, I imagine we would start by applying this solution to the worse cases, such as people with extremely advanced dementia. It is all too easy for people to convince themselves that surely these unfortunate people deserve the “mercy” of a lethal injection. And there you have it: A Final Solution to the problem of too many old people. And that will be the next Holocaust.
Before it comes to that, I expect a great increase in the incidence of neglect and abuse in nursing homes, as well as “mercy killings” done by nursing home staff on their own initiative, followed, in many cases, by their acquittal in our courts. Much of this would be due to the shortage of employees and the need to hire people who are incompetent and/or of questionable character. When you have to hire anyone you can get to take care of the elderly, the likelihood that they will be treated humanely diminishes markedly.
This will tend to create an atmosphere in which euthanasia will be seen as a solution. After all, people will say, these people are suffering so much, and “putting them down,” like sick dogs and cats, would be an act of mercy.
When I predict things like this, I generally get a reaction along the lines of “that can’t happen in America.” But when respect for life is gone, people are very self-centered, there is a huge number of old people whose support and care are very expensive, and solutions consistent with the moral law are very difficult, it can happen anywhere, because it is the path of least resistance. (Note that, some years back, many Germans thought things like this couldn’t happen in Germany.)
A professor of mine argued, many years ago, that the only real sociological law is one that says, “Most people, most of the time, follow the path of least resistance.” The converging developments cited above certainly make euthanasia the path of least resistance.
In spite of all this, I hope and pray that we will find in ourselves the faith, hope, and charity that will enable us to go against the path of least resistance, but I am not optimistic. The precedent given us by 50-60 million abortions done in America since 1973, is not encouraging. Yet, let us hope and pray — and work.
(© 2017 George A. Kendall)
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