An interesting op-ed in today’s Washington Post by Leon Kass, the Chairman of the President’s Council on Bioethics.  He focuses on our ethical obligation to provide close and loving care of aging elders, an issue of increasing significance in the graying US, and he makes some trenchant cultural critiques:

  Our culture’s generalized anxiety about old age and dying focuses all too
narrowly on end-of-life decisions and on preserving the fiction of autonomy in
the face of unavoidable neediness…

But this emphasis on autonomy ignores the truth of human interdependence and of
our unavoidable need for human presence and care, especially when we can no
longer take care of ourselves…

    And it it precisely because of our cultural blinders, which block our view of inescapable interdependence, that we have to reach out to other cultural resources – like Confucianism and Taoism – to get a fuller picture of the dynamics of Humanity.

     Our over-emphasis on autonomy too often turns us inward, to consider self-interest in isolation, instead of seeing our selves realized in our relations with others.  I am as liable of this as any American; it is deeply culturally ingrained and powerfully reproduced through multiple media.  It is hard for us even to conceive of what a happy life would be (or a moral life or a legal life) without a strong sense of personal autonomy and self-possession. 

   It is that sense of separate and independent self that feels wounded when we have to give ourselves over to the care of others.  Taking care of a sick or dying parent – or a disabled child – is often culturally framed as a burden, or a bother or, even, a tragedy.  Not everyone is this way (I can think of some people I  know who truly thrive in care-giving), but the culture (and this is not just an American thing, but a modernist, global thing) works against an embrace of care-giving.

      A Taoist would, of course, scoff at the notion that we are autonomous.  We are embedded in Way, swept, uncontrollably, on the currents of Way, and always already existing in the natural context of Way.  The naturalist perspective (the idea that humans are no more significant in Way than any other natural element, say, a strand of hair) leads Taoists to see aging as an utterly inevitable and acceptable process.  There is no loss; there is only another of an unending chain of transformations.  As to care, I think a Taoist would take a somewhat neutral stance: caring for others would not necessarily improve your life, though being with others as they age, sharing that transformation, even participating in it, would be something a friend might want to do or, at least, something that a friend should not fear doing. 

      A Taoist would have more to say to the person aging than the care-giver helping the aged person.  And to that aging person, a Taoist might say: relax.  Its not surprising or bad.  It just is.  You should not assume that some sort of personal autonomy – a mere mental construction in any event – will stop the process of decline and, ultimately, death.  You shouldn’t desperately try any and all means to "prolong life," an impossible goal.  You should celebrate the time you have left, make that life easier for yourself and your friends and care-givers, and go gentle into that good night.

     A Confucian, too, would reject the idea of personal autonomy.  But for a Confucian autonomy is limited by our social relations.  We are never outside the web of interaction with others; indeed, it is in that web that we find ourselves. 

   A Confucian would have more to say to the care-givers.  To them, he would say that their work is the morally best work that can be done.  It is precisely through the loving care of close family members (and, by extension, others outside the family) that we come closes to the highest achievement of Humanity.  It is how we are defined as moral persons. 

    If these ideas had any influence on government policy-makers, a Confucian world-view would encourage maximum support for care givers (publicly-supported aides to help with care; time off from work to provide care; access to supplies needed for care; etc.), all predicated on extensive participation by immediate family members. 

    A Taoist policy proposal (perhaps an oxymoron?) would take aim at the aging person, maybe even limiting the possibilities for the artificial extension of life.  But that might be beyond what most autonomous Americans, and even Leon Kass, are willing to accept…