James Brody
September 5th, 2006, 03:33 PM
The Last Medicare Dollar: Inclusive Fitness, Kinship, and Being Average. Taken from "Suicide: 'Mother, May I?,'" ISHE, Detroit, 2006
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There are at least three motives that elderly people commit suicide.
1) Many activities are less fun as if we ordered a beer and it arrived late, warm, and flat. Declining levels of dopamine, testosterone, and possibly serotonin start in our late teens and continue for the rest of our life. We have less initiative, less persistence, and less muscle mass. We become more passive, more prone to confusion and depression, and acquire a greater sensitivity to darkness, pain, and cold. Our situation is stabilized by medicine?s attitude that each of us is to have not the chemistry of a thirty-year-old but that of someone 60. Our physicians expect old behavior and maintain it in a perverse application of regression-to-the-mean.
2) We become expenses for our kin and for everyone connected to them. This is a problem even for people who have no children or siblings. Frank Salter?s analyses, for example, suggest that the average kinship between any two ethnics within a common border is approximately that of first cousin! (Rushton, 2005) We also move into a different era in which our producing fewer children means that each of them will spend more on each of us. And the costs increase every year. For example, ninety-five percent of health costs for an average life occurs in its last six months (Trivers, October, 2002). Join this fact to de Cantanzaro?s finding that older people are more apt to think of suicide when they face illness, isolation, and poverty. They lose their homes and bank accounts while giving them to everyone else?s children through a government agency. Health care harvests assets from old people and both sides, the dying and their caretakers, scheme.
3) We do not match the preferences of the next generation. We face alien television programs, jokes, and toys in the land that was ours. We often do not ?fit in? except with other older people and many of us prefer to withdraw. Societies may not only respond to these factors but also lead them as in some of Kuromoto?s oscillators that come into sync, Lewontin?s concept of environments and occupants that form ?constructions,? or the idea of gene-culture evolution (Strogatz, 2003; Lewontin, 2000; Richerson & Boyd, 2005).
Colt details some of these changes in the Netherlands where euthanasia has been described as the ?Dutch cure for suicide.? (Herbert Hendin, cited by Colt, 2006, p. 426). Among Hendin?s other findings: about 25 percent of Dutch physicians have assisted suicides but roughly half of them proceed without formal consent or peer approval from the client, and health professionals report that requests for euthanasia come more often from family members than from the patient. Not all responsibility rests on families, however. One Dutch physician explained that he overdosed a patient because he needed the empty bed and the patient would have taken another week to die on her own (Colt, 2006, p. 424).
Increasing portions of the American population have a similar conflict between waiting and expedience: ?prevent suicide? becomes ?why bother?? which, in turn, becomes ?Why not speed it up?? The demographics of the clients, there are lots of them and in high turnover, and the caretakers, also lots of them in high turnover, make both clients and caretakers interchangeable and biased toward the ?cheat ?em? provisions of tit-for-tat! Salter?s findings have another implication. Congregate care depends ever more on new immigrants. As average relatedness between caretaker and receiver declines, expect lower standards for care, less warmth when it is given, and a briefer need for it because people check themselves out early.
Once more, human natures make and follow opportunities.
Adaptations help each of us to get our way as we make the settings that are available match our genetic propensities.
Adaptations are, thus, tools not just for survival but for both satisfaction and rebellion. If suicide is to be considered an adaptation, any mystery about suicide and suicidal thoughts may be not that they occur but that we seldom admit to them. If de Catanzaro was correct about inclusive fitness, many more elderly will want to leave sooner rather than later. And regression to the mean predicts that if we discard sanctions against suicide, then lines might form as they now do for business commuters out of JFK, LaGuardia, or Logan.
And many more families would buy the tickets.
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There are at least three motives that elderly people commit suicide.
1) Many activities are less fun as if we ordered a beer and it arrived late, warm, and flat. Declining levels of dopamine, testosterone, and possibly serotonin start in our late teens and continue for the rest of our life. We have less initiative, less persistence, and less muscle mass. We become more passive, more prone to confusion and depression, and acquire a greater sensitivity to darkness, pain, and cold. Our situation is stabilized by medicine?s attitude that each of us is to have not the chemistry of a thirty-year-old but that of someone 60. Our physicians expect old behavior and maintain it in a perverse application of regression-to-the-mean.
2) We become expenses for our kin and for everyone connected to them. This is a problem even for people who have no children or siblings. Frank Salter?s analyses, for example, suggest that the average kinship between any two ethnics within a common border is approximately that of first cousin! (Rushton, 2005) We also move into a different era in which our producing fewer children means that each of them will spend more on each of us. And the costs increase every year. For example, ninety-five percent of health costs for an average life occurs in its last six months (Trivers, October, 2002). Join this fact to de Cantanzaro?s finding that older people are more apt to think of suicide when they face illness, isolation, and poverty. They lose their homes and bank accounts while giving them to everyone else?s children through a government agency. Health care harvests assets from old people and both sides, the dying and their caretakers, scheme.
3) We do not match the preferences of the next generation. We face alien television programs, jokes, and toys in the land that was ours. We often do not ?fit in? except with other older people and many of us prefer to withdraw. Societies may not only respond to these factors but also lead them as in some of Kuromoto?s oscillators that come into sync, Lewontin?s concept of environments and occupants that form ?constructions,? or the idea of gene-culture evolution (Strogatz, 2003; Lewontin, 2000; Richerson & Boyd, 2005).
Colt details some of these changes in the Netherlands where euthanasia has been described as the ?Dutch cure for suicide.? (Herbert Hendin, cited by Colt, 2006, p. 426). Among Hendin?s other findings: about 25 percent of Dutch physicians have assisted suicides but roughly half of them proceed without formal consent or peer approval from the client, and health professionals report that requests for euthanasia come more often from family members than from the patient. Not all responsibility rests on families, however. One Dutch physician explained that he overdosed a patient because he needed the empty bed and the patient would have taken another week to die on her own (Colt, 2006, p. 424).
Increasing portions of the American population have a similar conflict between waiting and expedience: ?prevent suicide? becomes ?why bother?? which, in turn, becomes ?Why not speed it up?? The demographics of the clients, there are lots of them and in high turnover, and the caretakers, also lots of them in high turnover, make both clients and caretakers interchangeable and biased toward the ?cheat ?em? provisions of tit-for-tat! Salter?s findings have another implication. Congregate care depends ever more on new immigrants. As average relatedness between caretaker and receiver declines, expect lower standards for care, less warmth when it is given, and a briefer need for it because people check themselves out early.
Once more, human natures make and follow opportunities.
Adaptations help each of us to get our way as we make the settings that are available match our genetic propensities.
Adaptations are, thus, tools not just for survival but for both satisfaction and rebellion. If suicide is to be considered an adaptation, any mystery about suicide and suicidal thoughts may be not that they occur but that we seldom admit to them. If de Catanzaro was correct about inclusive fitness, many more elderly will want to leave sooner rather than later. And regression to the mean predicts that if we discard sanctions against suicide, then lines might form as they now do for business commuters out of JFK, LaGuardia, or Logan.
And many more families would buy the tickets.