Why the world wants old people to 'hurry up and die'

Japan’s Deputy Prime Minister Taro Aso has a notorious record of saying politically incorrect things – even if they occasionally have a kernel of truth in them. In 2009, for instance, while serving a brief term as Prime Minister, Aso counselled a group of university students that poor people should not get married, and that those who don’t earn much money were unworthy of respect from a potential life companion.

The economic and sociological merit of Aso’s point may have been well taken, but the lack of subtlety in its articulation left Japanese people reeling, as if they’d been biffed on their heads with a blunt instrument.

Last week, Aso was at it again, with all the subtlety of a heavyweight boxer in a prizefight. While addressing a meeting convened to address social security issues in debt-ridden Japan, particularly the economic burden imposed by elderly patients whose lives were being prolonged with treatment, Aso was his usual crude self.

People with serious illnesses should be allowed to die quickly if they wanted to, he said. “Heaven forbid if I should be kept alive if I want to die,” Aso said. “You cannot sleep well when you think it’s all paid by the government. This won’t be solved unless you let them hurry up and die” (emphasis added).

Aso’s comments merely channel arguments around the world in favour of “assisted suicide” – where people, typically those who are seriously ill, seek the “right to death”. Assisted suicide is legal in certain countries and jurisdictions, for instance in Belgium, Luxembourg, the Netherlands, Switzerland and some States in the US.

Even so, Aso’s remarks whipped up a storm of protest in Japan, which has the among the world’s highest life expectancy at birth and the most “grey” population in the world. Following the outrage, Aso retracted his remarks, acknowledging that they had been inappropriate. But his comments have served to refocus attention on one of the sternest challenges ahead for societies – in Japan and around the world, including in India – in dealing with rapidly greying populations and the costs of supporting everything from healthcare needs to pension payouts.

In parts of India, for instance, where there exist no social welfare safety nets to support the elderly, low-income families who cannot always afford the healthcare and other living expenses of their elderly relatives resort to crude euthanasia practices – of the sorts that Aso would perhaps have approved of.

For instance, this report in the Los Angeles Times last week chronicled the experience of families in some southern districts in Tamil Nadu, where a home-grown version of euthanasia has been in practice for decades – and perhaps even centuries.

The practice, known as thalaikoothal (literally, “head pouring”), manifests itself in many ways. Typically, when an elderly relative becomes seriously ill and the family cannot afford to provide for the person, a date for the thalaikoothal ceremony is set, and sometimes even relatives are invited to participate.

“The victim is given an oil bath, a head massage perhaps involving cold water and an exceedingly large amount of green coconut milk, leading to death,” the Los Angeles Times report noted in dispassionate prose.

Evidently there’s a morbid science that underlies the thalaikoothal mercy-killing. Lowering a sick or frail person’s body temperature abruptly – in the way that a head massage with cold water and coconut milk can do – can bring on heart failure, according to a doctor quoted in the report.

Alternatively, the elderly relative who is being prepared for “mercy-killing” may be given excessive liquids to — which can induce renal failure — or force-fed cow’s milk while having their nose pinched shut — which results in them choking to death.

“Some call it euthanasia,” Rajeshwar Devarakonda, social protection head at HelpAge India, a civic group focused on elderly care, told the newspaper. “Others call it homicide.”

With India’s population of elderly (65-and-over) set to quadruple by 205o – and with inadequate provision of social welfare support for the poor and the elderly – the borderlines of ethics are bound to be repeatedly breached, as the instances of thalaikoothal in pockets of Tamil Nadu establish.

The problem of caring for the elderly is particularly acute in developing societies like India, but even developed economies are not immune to it. According to US economists, America’s debt problem– which has already hit monstrous proportions and still growing – will be further compounded by the pension and Medicare payouts that will have to be made when the “Baby Boomer” generation begins to retire.

One characteristic of this ‘Baby Boomer’ generation in the US is that it did not save for retirement or healthcare, but will nevertheless begin to demand social welfare payouts in a few years’ time as it retires, observes economist Russell Napier.

They began life as the ‘Grateful Dead’ generation – given to hard rock, acid and other markers of the Baby Boomers. But they will ending their lives as the ‘Ungrateful Undead’ generation, says Napier, only half in jest.

Already, the strains of providing for old-age are beginning to manifest themselves in other developed economies like Japan. Japanese people have among the world’s highest life expectancy at birth (79.44 years for men and 85.9 years for women), and Japan has among the world highest population of centenarians. So skewed is Japan’s demographic profile and so grey is Japanese society that last year, for the first time, sales of adult diapers exceeded diapers for babies ( more here ).

Together with a low birth rate, Japanese people’s longevity is feeding an avalanche of saving to provide for old age, which, economists say, is cramping consumption and dragging drag the economy.

It is also spawning sociological problems, as the officials in the Japanese census bureau noticed last year. When census officials went to congratulate a 111-year-old man, who was believed to be the oldest in Tokyo, what they found instead was his mummified remains. He had died nearly 30 years earlier, but his relatives had not informed the authorities because they were still collecting his pension income, for which they would become ineligible if they notified his death. (More on that here ).

Aso’s wish that the terminally sick and the elderly would “hurry up and die” may have been crudely put, but it appears from the experience of societies around the world, including in India, that that wish is more widely shared. Different societies deal with them in different ways. In India, the elderly are slowly snuffed out. In Japan, their mummified bodies are preserved for eternity so that relatives may life off their pension earnings. For the elderly, it seems, there is dignity neither in life nor in death…