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My colleague Paul Scherz, an associate professor of moral theology and ethics at The Catholic University of America, and I are co-editors of a new book The Evening of Life: The Challenges of Aging and Dying Well. The Evening of Life examines the challenges of aging and dying well and calls for a re-envisioning of cultural concepts, practices, and virtues that embrace decline, dependency, and finitude rather than stigmatizes them. The following is an interview with our publisher, Notre Dame Press.
When did you first get the idea to edit this book? Why did you feel compelled to gather these essays on the ethics of aging and dying well?
Along with colleagues in the Picturing the Human Colloquy at the Institute for Advanced Studies in Culture at the University of Virginia, we share a concern with the question of human flourishing—how does one live well and under what sort of social arrangements? In our discussions and reading groups, we have explored the central place of individual autonomy in our society, a topic that led us almost inevitably to the issues of aging and dying.
In most cultures, there is a vision of a good life that takes different forms at different stages between birth, youth, adulthood, old age, and death. But not in ours. We lack a distinct vision of what it means to flourish in old age and regard as success a life lived fully active until a brief period of decline and death. There are few guidelines and rituals that help us confront and incorporate the realities of physical decline, dependency, and changed social status that typically accompany old age, the loss of loved ones, and finally our own death. The relative paucity of positive visions of later life led us to develop a research project to explore the impediments to and possibilities for such flourishing in our society.
Certainly, these are unprecedented times for the elderly during the coronavirus pandemic. What can medical practitioners, clinicians, bioethicists, and others involved in the care of the aging and dying learn from this book?
Our responses to the pandemic have demonstrated the basic message of the book: We, as a society, are deeply ambivalent toward the oldest and most vulnerable among us. Our unprecedented stay-at-home and distancing mandates were in part efforts to protect the elderly, yet, as the numbers show, we have in fact done a very poor job in many cases. Our inattention to the distinct circumstances of the aged has left nursing facilities and care homes exposed, while, at the same time, realizing some of the greatest fears of the elderly: social isolation and a lonely death.
In terms of practical responses, this book emphasizes the importance of community and relationships for those in later life. Given the well-documented problem and fear of loneliness among the elderly, it is essential during the pandemic that we find ways to allow more access to them by family and friends, especially if they are suffering from dementia or approaching death. In the longer term, authors in the book outline simple, inexpensive approaches that could allow more of the elderly to spend a longer period of time in their own homes in their own communities, which could dissipate some of the risks associated with the setting of care homes.
Why did you select certain contributors for this volume? What do they bring to the discussion?
From the first, we realized that this question could only be addressed in an interdisciplinary way, so we sought out the people who were doing really interesting work on this question from a wide variety of fields. We were fortunate to have all the scholars we asked agree to contribute—they recognize what an important issue this is.
There are essays addressing the big theoretical questions: How does our society shape the vision of old age? How can philosophical and religious perspectives help us to confront finitude and dependency? But there are also contributions getting into the nitty-gritty details that make a difference in daily life: How do medical reimbursement mechanisms affect the care of people in later life? Who actually takes care of people with Alzheimer’s disease? What mechanisms exist to help people stay in their homes? These many perspectives enrich each other, overlapping in unexpected ways, and show the many possible avenues that exist to improve later life.
How does this book contribute to contemporary conversations or events?
We are a rapidly aging society, so perhaps there is no more important question than how our later years can go well and be lived well. This question involves addressing practical policy issues of designing, managing, and funding social programs, on which there are many works and which we, too, tackle. It involves the reshaping of our social institutions, our cities and our homes, our families and friendships, in ways that mark our old age as a distinct and valuable life stage. And, perhaps even more essentially, it involves each of us, at whatever stage of life, learning how to adjust ourselves to the reality of our own limitations, not in an attitude of despondence and despair, but in a way that allows us to explore the joys and opportunities that exist exactly in our finitude.
Who is the biggest influence on you and your work?
If we had to pick out a single thinker, it would be Alasdair MacIntyre. In his major works starting with After Virtue, he underlined the importance of the question of human flourishing, how the understanding of it differs among various societies and the problems of our own culture in confronting questions of finitude and the unity of a life. MacIntyre’s later work on disability shows the need to understand how we can flourish while still accepting our innate dependency. We can do so only by addressing these problems at both the level of individual virtue and communal practice. Later life provides an important context for developing his work on flourishing, virtue, and dependence.
Who would you like to read The Evening of Life and why?
We of course would like scholars and students studying these issues to read this book. The book brings together a number of humanistic scholars to address an urgent question that can enhance the way that the fields of medicine, public health, sociology, and ethics are addressing old age. We also think this book would be important for a more general audience. We all, barring accident or illness, will face the problems and opportunities of aging. Many of the essays in this book explore how we as individuals can change how we approach these later years, how we can engage lost abilities as chances for growth, how we can continue to engage in community and deepen our relationships.
