The Evening of Life

Description

Although philosophy, religion, and civic cultures used to help people prepare for aging and dying well, this is no longer the case. Today, aging is frequently seen as a problem to be solved and death as a harsh reality to be masked. In part, our cultural confusion is rooted in an inadequate conception of the human person, which is based on a notion of absolute individual autonomy that cannot but fail in the face of the dependency that comes with aging and decline at the end of life. To help correct the ethical impoverishment at the root of our contemporary social confusion, The Evening of Life provides an interdisciplinary examination of the challenges of aging and dying well. It calls for a re-envisioning of cultural concepts, practices, and virtues that embraces decline, dependency, and finitude rather than stigmatizes them. Bringing together the work of sociologists, anthropologists, philosophers, theologians, and medical practitioners, this collection of essays develops an interrelated set of conceptual tools to discuss the current challenges posed to aging and dying well, such as flourishing, temporality, narrative, and friendship. Above all, it proposes a positive understanding of thriving in old age that is rooted in our shared vulnerability as human beings. It also suggests how some of these tools and concepts can be deployed to create a medical system that better responds to our contemporary needs. The Evening of Life will interest bioethicists, medical practitioners, clinicians, and others involved in the care of the aging and dying.

Contributors: Joseph E. Davis, Sharon R. Kaufman, Paul Scherz, Wilfred M. McClay, Kevin Aho, Charles Guignon, Bryan S. Turner, Janelle S. Taylor, Sarah L. Szanton, Janiece Taylor, and Justin Mutter

While not unique to old age, the ongoing dissolution of the life course has been especially significant for old age, where the role of a defining community to provide direction and criteria for meaning is most obvious and essential. Aging, decline, and approaching death are some of the most complex and unsettling aspects of human experience. While historically strengthened and mediated by rites of passage, kinship networks, filial duty to ancestors, hierarchies that honor wisdom, social practices that superintend grief, and arts of suffering and dying, today’s older adults invariably find such common symbols or shared traditions weakened. In our time, meaning in old age has become more subjective and private.
The task of preparing people for their later years, once a central cultural and philosophical task, has correspondingly waned. While the ideal form of character in the face of aging and death has varied by time and school of thought, social and cultural goals were nonetheless broadly similar. Social philosophies, religious communities, and civic cultures helped guide people in a process of preparing for aging and dying “well.” Such normative guidance and inspiration did not necessarily mean that old people were given special respect or honor, or that old age was treated as a social category deserving of special treatment or public concern. Social histories tell an ambiguous story, with critical variation in respect accorded to different social groups. But social norms of aging and dying did provide direction and shared expectations about how to live. One need only consider the many current debates that frame aging as a problem to be solved—with “successful aging,” or anti-aging interventions, or “engineered negligible senescence,” or assisted suicide—to see our communal and ethical quandary. We have precious few resources for even thinking about the enduring questions of a good old age, its meaning as a distinctive phase in the life course or stage in life’s pilgrimage, and how we might prepare for and embrace the twilight years of life.
Our cultural impoverishment is rooted, most fundamentally, in a deficient conception of the person in society. Our dominant image of persons as free and unencumbered agents, as masters of choice, while inadequate at every stage of life, is especially detrimental in the last. Liberal, autonomous individualism provides virtually no criteria to inform our choices beyond personal preference. It situates us under a regime that effectively fixes aging and death as realities to hide; that works to undermine our ability to cope with our finitude and inevitable decline; that makes it difficult to sustain a valued sense of self in the face of dependency, disability, and an aging body; and that works against a positive conception of living in older age. It is a regime that offers little grounds for social solidarity across the generations or reasons to strengthen it.
In our moment, the societies of the industrialized world urgently need an ethics of aging that centers on the question of a good human life in its later years—an old age that is lived well and that goes well. Toward this ethics there are currently only scattered contributions. Most of the existing literature might best be described as ethical reflection on issues that predominantly involve older people. This is an abstract ethics focused on rights and duties and decision-making in legal matters and care in the context of formal institutions. It is not an ethics of everyday life for those navigating their twilight years. Of course, protections are crucial in hospitals, nursing homes, and other institutions where older people are especially vulnerable. An essential element of a good life is one in which people are treated justly, and an ethics of the person includes obligations. But a substantive, normative ethics of aging must concern aging persons in all their complexity, and go beyond a concern with negative liberty.

We need to re-envision a robust set of cultural concepts, practices, and virtues for advanced age and death, for individuals as well as communities. We need a positive image of living in old age, rooted in our shared potentiality and vulnerability, an image that engages our creativity and generativity juxtaposed with our frailty, our dependence, and our finitude. We need a holistic orientation to aging persons that is capable of guiding and delimiting interventions, whether medical or quality of life. We need, in short, an ethics of aging that takes up conceptions of well-being in the evening of life and their complex interplay with the cultural frameworks, social arrangements, and technologies that impact those conceptions and might be shaped to sustain and satisfy them.

Toward such an ethics, this book is an intervention.

Sujets

• Philosophie
• Éthique et morale
• Vie de famille
• Soutien psychologique et conseils familiaux
• Dying
• Social Science
• Bereavement
• PHILOSOPHY
• Sociologie, société et politique
• Ethics
• Grief
• Death

Informations

• Publié par: University of Notre Dame Press
• Date de parution: 30 septembre 2020
• Nombre de lectures: 0
• EAN13: 9780268108038
• Langue: English

Extrait

the evening of life

Copyright © 2020 by the University of Notre Dame
Notre Dame, Indiana 46556
undpress.nd.edu
All Rights Reserved
Published in the United States of America
Excerpts from W. B. Yeats’s “Among School Children” and “Sailing to Byzantium” in chapter 4 are printed with the permission of Caitriona Yeats.
Library of Congress Control Number: 2020940875
ISBN: 978-0-268-10801-4 (Hardback)
ISBN: 978-0-268-10802-1 (Paperback)
ISBN: 978-0-268-10804-5 (WebPDF)
ISBN: 978-0-268-10803-8 (Epub)
This e-Book was converted from the original source file by a third-party vendor. Readers who notice any formatting, textual, or readability issues are encouraged to contact the publisher at [e-mail]
CONTENTS
Acknowledgments
Introduction: Toward an Ethics of Aging
Joseph E. Davis
PART I. OUR DEFICIT MODEL OF AGING
ONE . The Devalued Status of Old Age
Joseph E. Davis
TWO . The Structural-Ethical Source of the Matter:
The Medical-Industrial Complex
Sharon R. Kaufman
THREE . Beyond Avoidance and Autonomy
Paul Scherz
PART II. LIVING OLD AGE WELL
FOUR . Epiphanies, Small and Large
Wilfred M. McClay

FIVE . The Contraction of Time and Existential Awakening:
A Phenomenology of Authentic Aging
Kevin Aho
SIX . The End of the Story: A Narrativist View of Life’s Finale
Charles Guignon
SEVEN . Happiness and Aging: An Unlikely Combination?
Bryan S. Turner
PART III. AN OLD AGE THAT GOES WELL
EIGHT . Friendship, Citizenship, and Abandonment:
Older Adults with Dementia and without Family Caregivers
Janelle S. Taylor
NINE . The Priority of Social and Physical Function:
Older Adults in the CAPABLE Program
Sarah L. Szanton and Janiece Taylor
TEN . From Diagnosis to Person-Focused Prognosis:
Toward a Healthy Political Economy of Aging in America
Justin Mutter
Conclusion
Paul Scherz
Contributors
Index
ACKNOWLEDGMENTS
In March of 2018, we editors of this book held a conference on the ethics of later life at the Institute for Advanced Studies in Culture (IASC) at the University of Virginia. Many of the essays published as chapters here were first presented at that conference, with others prepared for this book. We owe a special debt to all of the conference participants. Given a storm that hit Virginia the day of the conference, many underwent heroic journeys just to be present. We thank those who prepared essays, including Thomas Pfau (whose paper is being published elsewhere), for their careful scholarship and generous responsiveness to the feedback of the conference discussants. The discussants were Anne Allison, Daniel Becker, Tal Brewer, James Mumford, China Scherz, and Jarrett Zigon. Their incisive comments on individual papers and vigorous engagement throughout the conference contributed much to the work that is found here.
We would also like to thank our colleagues in the Picturing the Human colloquy at the IASC — Tal Brewer, Matthew Crawford, and, especially, Justin Mutter — as well as Travis Pickell, for help in the initial work of conceptualizing the conference. The support of the IASC was critical, and, as always, we thank James Hunter and Ryan Olson. Kelly Blumberg provided first-rate administrative support and, along with Donita McCormick-Fortune and Vivienne Smith, saved the day with flexible and creative solutions to the many logistical challenges caused by the bad weather.
Kevin Aho, Wilfred McClay, and Bryan Turner were not able to attend the conference but subsequently prepared essays for this volume. This book is much stronger for their signal contributions.

We greatly appreciate the enthusiastic support of Stephen Wrinn, director of the University of Notre Dame Press, and for all his advice. We thank the three anonymous reviewers for the Press, from whose thoughtful and detailed comments we profited. And we would like to express our gratitude to Mariele Courtois for her careful editorial assistance and to Marilyn Martin of the Press for her graceful copyediting.
Immediately after the conference, somewhat more popular versions of the essays by Davis, McClay, and Mutter were published in the Fall 2018 number of the IASC’s journal, The Hedgehog Review. We thank the editors of the Review, whose helpful editing was largely incorporated into the versions of the essays published here.
Introduction
Toward an Ethics of Aging
JOSEPH E. DAVIS
At other times and in other places, traditional ways of life, social classification, and metaphysical order gave shape and coherence to the course of life. The periods of aging, decline, and the approach of death were especially critical. They involve some of the most complex and unsettling aspects of human experience, and so the need for a defining community to provide direction and meaning was most acute. Many social and cultural practices, such as rites of passage, kinship networks, filial duties to ancestors, hierarchies that honor wisdom, social customs that superintend grief, and arts of suffering and dying, provided support and mediation for this time of life. In our “liquid times,” by contrast, both in the Western world and beyond, common symbols and shared traditions of old age have weakened or disappeared altogether. 1 The meaning of the evening of life has become more subjective and private.

The task of preparing people for their later years, once a central cultural and philosophical task, has correspondingly waned. While the ideal form of character in the face of aging and death has varied by time and school of thought, social and cultural goals have nonetheless been broadly similar. 2 Social philosophies, religious communities, and civic cultures have helped guide people in a process of preparing for aging and dying “well.” Such normative guidance and inspiration have not necessarily meant that old people have been given special respect or honor or that old age has been treated as a social category deserving of special treatment or public concern. Social histories tell an ambiguous story, with critical variation in respect accorded to different social groups. 3 But social norms of aging and dying did provide direction and shared expectations about how to live. One need only consider the many current debates that frame aging as a problem to be solved — with “successful aging,” or anti-aging interventions, or “engineered negligible senescence,” 4 or assisted suicide — to see our communal and ethical quandary. We have precious few resources for even thinking about the enduring questions of a good old age, its meaning as a distinctive phase in the life course or stage in life’s pilgrimage, and how we might prepare for and embrace the twilight years of life.
Our cultural impoverishment is rooted, most fundamentally, in a deficient conception of the person in society. Our dominant image of persons as free and unencumbered agents, as masters of choice, while inadequate at every stage of life, is especially detrimental in the last. Liberal, autonomous individualism provides virtually no criteria to inform our choices beyond personal preference. It situates us under a regime that effectively fixes aging and death as realities to hide; works to undermine our ability to cope with our finitude and inevitable decline; makes it difficult to sustain a valued sense of self in the face of dependency, disability, and an aging body; and works against a positive conception of living in older age. It is a regime that offers few grounds for social solidarity across the generations or reasons to strengthen it.
In our moment, the societies of the industrialized world urgently need an ethics of aging that centers on the question of a good human life in its later years — an old age that is lived well and that goes well. 5 Toward this ethics there are currently only scattered contributions. 6 Most of the existing literature might best be described as ethical reflections on issues that predominantly involve older people. This is an abstract ethics focused on rights, duties, and decision-making in legal matters and care in the context of formal institutions. It is not an ethics of everyday life for those navigating their twilight years. Of course, protections are crucial in hospitals, nursing homes, and other institutions where older people are especially vulnerable. An essential element of a good life is one in which people are treated justly, and an ethics of the person includes obligations. 7 But a substantive, normative ethics of aging must concern aging persons in all their complexity and must go beyond a concern with negative liberty. We need to re-envision a robust set of cultural concepts, practices, and virtues for advanced age and death, for individuals as well as communities. We need a positive image of living in old age, rooted in our shared potentiality and vulnerability, an image that engages our creativity and generativity juxtaposed with our frailty, our dependence, and our finitude. We need a holistic orientation to aging persons that is capable of guiding and delimiting interventions, whether medical or pertaining to quality of life. We need, in short, an ethics of aging that takes up conceptions of well-being in the evening of life and their complex interplay with the cultural frameworks, social arrangements, and technologies that impact those conceptions and might be shaped to sustain and satisfy them. 8
Toward such an ethics, this book is an intervention.
Old Age as a Problem
No matter how we mark its beginning, “old age,” as the English sociologist John Vincent has said, “is always the period of life before death.” 9 The Danish philosopher Søren Kierkegaard called it the “evening of life,” a time when life is beyond its afternoon but not yet at its nightfall. 10 Across history and across societies, what is meant by old age and at what point it commences varies considerably. Old age is a cultural category configured by kinship, economic systems, physical capacities, and basic value orie