We all fear death. Or better still, many of us do not actually fear death; we fear dying – the process. The fact is that we all know we have to get there. But we are the only “intelligent” animals who fear this process. Animals fear death but they do not contemplate dying. The culprit, of course, is the advances we have made in medicine and the predictive nature of the process of certain diseases. People often mention Huntington’s disease, Dementia, being permanently disabled.
However, this preoccupation with disease and dying is creating too much discussion that there are now what are known as “Death café’s”. Although the name sounds abhorring, they are basically media and on-media places where people discuss death. Although I do not really believe in the “culture of death”, there is a culture of “dying”. The cause of all this is fear. And fear is basically thought. We think too much. If one thinks too much about whether one is going to fall asleep, he or she disrupts the natural process and indeed does not fall asleep. We have all been there at some point, perhaps. But those who suffer from insomnia know that this fear feeds the insomnia itself. When people tell me that they will “try” (to diet, reduce alcohol or whatever) I explain that trying in itself is a prescription for failure. We should not try but do. Football players go out to win; if they “try” to win they are bound to lose.
This fear is compounded by the industry. We now think about so many issues – cholesterol, hypertension, diabetes, obesity, and so on, that we have lost out on enjoying life. I once visited a family who were celebrating the 88th birthday of the grandmother. They invited me for a piece of cake really and when the old dear asked for another piece they reminded her about her diabetes and gave her instead a mhux ahjar le?? I said, “give her a piece!!” If I get to live to that age I would be eating pastizzi and Maxim’s pizza. There are so many things which remove the freedom and joy of living.
Of course, this is the general practitioner speaking in me. We are trained to think about the “epidemics” of chronic illness. If there is an epidemic it is an epidemic of fear, which, unfortunately the medical and parasitic industry preying of doctor, have induced in us. We get people coming on television and handing a cream or a bottle of vitamins, into the screen – they are shrewd, as they know that we all fear for our health. Do you really think you need that bottle of vitamins? With Covid-19, suddenly all these vitamins were “boosting” our immune system. Do you really believe that? This is not good medicine, as all doctors know. People simply piggy-back on medicine and import and advertise and sell and get rich.
It is not that we should not beware of our health. Everything in moderation is good. What we should be afraid of is over-indulgence. It does not take medicine to show us that. Our reason saw from the very beginning that those who drank the man-produced alcohol in large quantities produced the “symptoms of drunkenness” (to quote Oscar Wilde). We all know the dangers of overeating, but today the media tells us to be skinny – too skinny in fact. Health follows the path of fashion unfortunately.
The culture of fear has made us fear all sorts of food, cholesterol, any pain which in our youth we would have brushed aside – and of course it culminates now with a fear of dying. We do not realise that a cure of a disease is simply a postponing of death. We should cure that which is curable but perhaps thinking too much about death makes us over-indulge in pseudo-cures and medicines, which remove the joy of life from us. Medicine, because of these demands has lost part of the art of healing through knowledge of the humanities because people demand prescriptions and solutions to their problems. A pill does not always do the trick. It takes some effort as well. We still get the tini xi haga ha nonqos, as if eating less did not count. In medicine, often, less is more.
Conversely it is important not to be our own worst enemies. What I say above does not of course mean that we should fear vaccination against Covid, just because the media-hungry moguls and unfair competition put a fear in people, and of course politicians, that vaccines are unsafe. The fact is that they are not. If they were, why did a couple of European countries this week give millions of Astra-Zeneca vaccines to our Eastern European neighbours. What is fodder for the goose is fodder for the gander – it follows that what is not fodder for the western goose ought not to be fodder for that eastern one. The fact is that it was all about fear. It is true that there are risks; as those unfortunate to have had relatives die know only too well. But would they tell the world not to develop a vaccine knowing that there is no such thing as a fool-proof vaccine?
Martha Nussbaum, a philosopher, wisely said that uncertainty and contingency disrupt the linear and predictability of things. If everything determined was to be worked out, we would know the future and life would be miserable. What makes life interesting is that we do not know when we are going to die. If I know I will develop dementia, it is natural for me to fear. Neither should I go in denial. But do I actually know what it would be like? Do we know what it is like to die? Perhaps it is not as bad as we think – we simply do not know and the fact is that as Nussbaum puts it, “contingency, an object of terror and loathing, may turn out to be at the same time wonderful, constitutive of what makes a human life beautiful and thrilling”.
What we ought to do, rather, is learn from our mistakes. The WHO certainly will learn that next time it should keep the virus restricted at its origin and not tell us to keep our borders open and then advise for solidarity. People at the borders knew better. It was common sense and not fear. This is what our brains are there for. The politicians soon followed suit. Was it a coincidence that the virus originated in the same place where there was a laboratory experimenting on that same virus? Our minds are there to make us think – but to think how to survive and live well and not to fear everything from death to life itself. Iona Heath, a former GP, philosopher and president of the Royal College of General Practitioners put it nicely, and said, “only because we do not understand everything and because we cannot control the future is it possible to live”.
So perhaps before we think about euthanasia and how we are going to die, why not enjoy our lives while we live? Why not argue instead for an investment in better end of life care? Comfort, at whatever cost, is good; killing someone is simply giving up not merely accepting defeat.
Pierre Mallia is Professor of Family Medicine and Patients’ Rights and teaches at the University of Malta. He chairs the Bioethics Research Programme of the Faculty of Medicine and Surgery. He also chairs the Bioethics Consultative Committee.
This article is his personal opinion and does not represent the opinion of any committee or Board he serves on.
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