Consent to Die

Dying is natural.  So is the desire to avoid death.  The desire to live is a basal instinct, one which usually continues long after mental capabilities, such as judgement and decision making, have declined.  

Today, most old people die of one of 5 causes: cancer, heart disease, lung disease, stroke, and dementia.  Before antibiotics and modern medicine, most people died of infection, usually within 3 days.

If an old person today dies of infection, their care is judged to be substandard.  Infections are relatively easy to treat.  Cancer, heart disease, lung disease, stroke, and senile dementia - those are hard to treat.  Hard to treat - and expensive and time consuming to treat.

Why would we want to let old people die from easy-to-treat causes?  Why would an old person choose to die of easy to treat causes?  How can an old person with dementia choose to die of an easily treated cause?

70% of deaths in the US occur upon the removal of a ventilator.

Dementia patients can often still speak their desires (though they can no longer reason) so they can still demand or be persuaded to get treatment for years after they are diagnosed with dementia.

Treatment means the doctors and medical establishment get paid.

Treatment means our society is spending its resources keeping alive those who have little benefit left to society.

A bladder infection in an old person is an indication of declining health and much greater probability of dying in the next  months.

As smoking declines, fewer cancer, lung disease, heart disease and stroke deaths might well mean more deaths by dementia.

The predicted epidemic in Alzheimer's is expected to be very costly to the developed world.

What if we were to let seniors with dementia die of infections, such as bladder infections?  What changes would we need to make to our medical system to allow such deaths?  What changes would we need to make so consent given by a person of sound mind could control that person's destiny years later when the mind is no longer sound enough to reason, but is still sound enough to speak? To speak the basal truth that all of us want to continue living?