Editorial: Imperfect endings
The body is temporary, but the soul is indestructible. That teaching from the Bhagavad Gita, which argues for treating death with equanimity and calm instead of fear and anger, finds resonance across ancient cultures, from Egypt to China. Yet, experts are warning that the world is today breaking with those millennia-old philosophies in its approach to death, with worrying consequences. Earlier this week, an international panel of 27 medical professionals cautioned in The Lancet that far too many people are dying a “bad death”, surrounded by masked nurses, tubes and machines rather than by the affection and care of their loved ones. A profound irony lies at the root of their concerns. Modern medicine has thrown up previously unthinkable cures for a range of diseases, while helping to delay the progression of illnesses that cannot yet be reversed. The unprecedented speed with which researchers around the world developed the vaccines to tackle the Covid-19 pandemic serves as potent evidence of how stunning advances in health sciences can save millions of lives.
Yet these very gains can place families and doctors in what is often an impossible predicament: what should be done when death is inevitable but can be delayed by a few more hours or days? Since a landmark 2018 judgment by the Supreme Court, passive euthanasia is allowed in India under very specific circumstances, when patients are suffering from terminal illnesses or are in a vegetative state. The apex court’s guidelines require a living will — a written testament from patients stating how they want to spend their remaining days. Relying on the wishes of relatives in the absence of a living will could lead to the misuse of euthanasia, especially with old patients, the Supreme Court warned. But few individuals and families fully confront the prospect of death and how to deal with it until it is imminent, and too late for patients to pen such a document.
Ultimately though, how humankind treats life and death in the future depends on how it chooses to view mortality. Billionaires like Jeff Bezos, Peter Thiel and Yuri Milner, and giant firms like Google are investing in research aimed at reversing aging. But can the same Silicon Valley mindset that has revolutionized everything, from retail to transport, stall death indefinitely? Will any such fixes only touch billionaires or will they make their way to ordinary people? What will that mean for the world’s population? Until there are clear answers to these questions, humankind might be best served by remembering one of the world’s oldest texts, the Epic of Gilgamesh, in which the eponymous king searches for a flower on the seabed that holds the power to restore his youth. But a snake eats the flower and Gilgamesh dies like everyone else. What has lived 20,000 years is that tale — and its immortal lessons on arrogance, ambition and human frailty.