Economics of death

In the end, Euthanasia is not about ethics but about money.

What price do you put on someone you love? That's the real and unasked question in the debate on passive enthanasia - terminating the lives of the incurably ill who are no longer conscious or capable of acting on their own. I recall a family's terrible dilemma which i found myself involved in some years ago.

One of the sisters in the family was stricken by an irreversible and fatal disease that attacks the auto-immune system and for which there is no known cure. The diagnosis had been made too late to try alternative therapies which might have deferred the inevitable. The patient - to whom i was not related but who was as close to me as if she were my own sister - went into a coma and was taken to a state-of-the-art medical facility in Delhi.

The moment she was admitted into the hospital, the patient, in effect, ceased to be a human individual with human attachments of family and loved ones and became instead the property of a team of medical specialists. No longer conscious of where she was or what was happening to her, she was put into an intensive care unit which no one could enter except those who were treating her. We could see her through a glass pane, attached to mechanical devices which took over from her the business of existence: the breathing of the lungs, the beating of the heart, the circulation of blood, the intake of nutrition. She became a machine, linked to other machines.

Regular as clockwork the attendant team of specialists would look in on the patient. Literally look in. Open the door, look at her from the doorway, make a note on clipboards they were carrying and go away. It was a large team and day by day it seemed to get larger. Who are all these people? I asked a nurse. Doctors, she replied.

What sort of doctors? I asked. Special doctors, said the nurse. They were indeed special doctors, as I discovered. One was a dietitian. Another was a dermatologist. Why did a patient unable to take in any nutrition other than through a drip need a dietitian to visit three times a day? No one knew. Why did the patient need a dermatologist's visit every day? No one knew.

But each time these specialists would look in on her, the visit would be put on the bill. Which, like the team of specialists, was daily growing bigger. It was, after all, a state-of-the-art private hospital. With high overheads, including specialists who occupied expensive offices and had to earn fees in order to pay their rentals.

Twice a day we'd go to see the head doctor. No, there was no change in the patient. No, no change could be expected. No one could bring themselves to ask the question that hung in the silence like a thunderclap: How long do we go on like this, how long can we go on?

The family was reasonably well off. But how long could they afford to keep the patient in the hospital? One month? Two? A year? There were other expenses to meet, a son to be educated, futures to be provided for. But how do you put a cut-off price on a life? Even on the life of a machine kept alive by other machines.

The family couldn't do it. So I volunteered. I told the head doctor there was no more money for the ICU, for the machines. The doctor looked thoughtful. I see, he said. There was no talk of the law, or of ethics. No talk of the sanctity of life. No talk of miracle cures.

Sometime that day, we weren't told when, the machines were switched off. The patient stopped being a patient and became a closed file and a final bill. Which the family paid, racked with remorse, feeling that what they were paying was blood money. Was this sum what a life was worth, no more and no less? To the loss of a loved one was added the burden of guilt.

Parliament can legislate on the ethics of euthanasia. Who's going to legislate on the economics of death, and the cost that conscience has to bear? What is the price of someone you love?

The Underage Optimist

Welcome to Republic India-Excellent

Yes, we did it! It took us 28 years but when we finally did win the Cup, we won it in massive style. We won at home, chasing the highest ever total of a World Cup final, recovered after the loss of two big batsmen, and with a stunning six as the victory shot. It is not possible, at the current moment, to praise the team enough. Their victory will give a lifetime of bragging rights and inspire an entire generation.

Equally stunning were the celebrations that followed right after the win. Even though it was close to midnight, within minutes, millions took to the streets. In something India has never witnessed before, there were impromptu victory processions, happy traffic jams, ecstatic people on the roads and a street party to which, literally, everyone was invited.

Why did we feel so great?  What makes this win so special and is there a bigger impact of the win that we can carry into our own lives. After all, as some may say, this is just a game. It has no tangible impact on ordinary Indians lives. Yet, there is no denying the mood-elevating effects of winning the biggest trophy of our biggest game. It is like a booster dose of self-esteem and hope administered to the entire nation.

To understand why this win is so big, it is important to understand the context in which this has come. This trophy comes at a time when the only remarkable news coming out of India was the scams, including a big one in sports. The only remarkable people were the corrupt politicians and their cronies. Many of these people roam free and are even celebrated by Indian society. This is India – connections, the clique of powerful people who scratch each others backs and give each other mutual access to their power to enhance it. This is the way people rise in India who you know is more important than what you know. How you trade your power for another persons power is the core skill that will make you rise in life.

In the middle of all this, our men in blue brought home the World Cup. It was not a competition of connections. It didn't matter who your father was, which minister was your best friend or how much money you had in the bank. Only one thing mattered excellence. For the only way to win this Cup was to play better than everyone else, in match after match. And we played better than anyone else.

Such global recognition is rare for India, but this win showed the way to another, more glorious, Indian path to success : India-excellent. The India-excellent way to success is still hazy, but the young generation is getting a whiff of it. And it smells a lot better than the stale odour of success generated by India-connections. In fact, young India loves the perfume of excellence. That is why the youth came out onto the streets at midnight for the players, but they wont for any politician. The success that comes from excellence feels good its like a fresh and juicy apple. The success from connections tastes like reconstituted fruit. From a distance they may look the same, but for the person achieving it, the feeling is worlds apart. You can't kiss a bribe the same way as Dhoni kissed the trophy. You can't celebrate an unfairly earned telecom license the way Team India did after the match.Your ill-gotten gains may win you some fake friends, but India-connections is just not the same flavour as India-excellent. India-excellent is cool, India-connections is not.

With this win, youngsters today can see two paths. As they grow up, they will have the choice of two roads. India-connections is a well-travelled road. It may be easier, but ultimately less rewarding. The India-excellent road that Dhoni and company have paved for us is the harder one. However, it is more meaningful and more rewarding.

The clash of these two India's will dominate the next two decades. Right now, India-connections has the upper hand. In the finals, tickets were essentially reserved for the India-connections. If you didnt have the right contacts, you couldn't get a ticket. This, ironically, for a contest that celebrates excellence. But i dare India-connections to contain India excellent. It won't be able to. Lurking beneath the tiny, creamy layer of India-connections is a talent pool so vast that it can transform our nation. One person's success can ignite the winning spark in millions of hearts. And Dhoni's men haven't just provided the spark, they have lit a fire. As a tribute to our team, let us resolve to win, and win using the path of India-excellent. After all, if we can be great at cricket, we can be great at anything. Let this trophy be the start of many Indian victories. Thank you, Team India, for making so many of us so happy.

RIGHT & WRONG

Hazare fills the void in corruption battle

Past two weeks back, India was trying to come to terms with a phenomenon they neither understood nor anticipated.

The abrupt emergence of Anna Hazare as the symbol of a largely middle-class outburst against the insincerity of the war on corruption had been puzzling. In many ways, this 71-year-old self-professed Gandhian from rural Maharashtra is a total antithesis of what modern India apparently stands for. He is neither young nor tech-savvy ; he doesn’t talk the ‘development’ jargon of well-travelled NGO activists; and his politico-cultural symbolism — Chhatrapati Shivaji, Swami Vivekananda, Mahatma Gandhi, Bharat Mata and Vande Mataram—is seemingly at odds with modernist impulses of India’s aspirational classes. Yet, Anna has become the unlikeliest symbol of a movement that may well end up unseating a government, even if it doesn’t succeed in cleansing public life.

Perhaps the lionization of another diminutive man with an infectious smile is an indication that the more India changes the more it remains the same. Nearly four decades ago, professor W H Morris-Jones observed that Indian leadership follows three idioms: the traditional, the modern and the saintly. The last fits uneasily into perceptions of Indian modernity or, for that matter, the caricatured view of its conservatism. But in the past 100 years, the most significant movements for change have been propelled by people who lived in a world of their own imagination and were driven by exacting ethical standards.

Frankly, you had to be a bit crazy in 1919 to dream of unseating the Raj. You also had to be very other-worldly to believe in 1973 — barely a year after Indira Gandhi’s anointment as “Durga” after the Bangladesh war — that the corrupt edifice of the Congress Party could be brought down. Maybe it is too rash as yet to place Anna on par with either the Mahatma or ‘Loknayak’ Jayaprakash Narayan — the two saintly crazies who reshaped 20th century India. Yet, it is important to recognize that being impractical has never been a deterrent to inspirational leadership, at least not in India.
 
There are many features of the alternative Jan Lokpal Bill proposed by Anna and his supporters that are either outrageous or quirky. The belief that a Lokpal appointed by a committee of the great and good should have overriding powers over an elected government is at best utopian and, at worst, anti-democratic. And the proposal of who should constitute the electoral college of the virtuous is, to say the least, eccentric. Why should all those of Indian origin honoured by the Nobel committee in Sweden and Norway and the last two Magsaysay Prize winners — chosen by a committee in the Philippines—be ex-officio members of a desi star chamber. Why not the recipients of the Padma Vibhushan and Bharat Ratna? Or for that matter, why not everyone honoured by the local Rotary Club?

The issue, fortunately, is neither the Lokpal Bill nor even the principle of ‘civil society’ representation in the drafting committee—a characteristically NGO-ish demand. The overwhelming majority of those inspired by Anna’s fast don’t seem all that preoccupied with the minutiae of a proposed legislation. What has excited them is the fact that someone of unimpeachable integrity has chosen to take a stand and confront a decrepit and smug system on the issue of corruption.
 
In 1921, when Mahatma Gandhi asked people to abandon schools, colleges, law courts, and resign from government service in the quest of swaraj in just a year, only a small handful actually did so. Indeed, many of India’s foremost intellectuals, including Rabindranath Tagore, were disturbed by what they saw as Gandhi’s reckless manipulation of impressionable young minds. But Gandhi’s larger moral appeal outweighed the shortcomings of his political strategy. The Mahatma became a national inspiration in the struggle for independence; Gandhism always remained a fad. A similar distinction marked JP, the symbol of resistance to Indira Gandhi’s authoritarian misrule and his woolly ‘Total Revolution’.

In the coming weeks, there will be fierce assaults, not least by rival ‘civil society’ activists, on the implications of Anna’s Jan Lokpal proposals. Some of these will be couched in lofty constitutionalism such as the sovereignty of Parliament ; others will be blended with competitive self-righteousness ; and still others will see Anna as an unwitting tool of the anti-Congress opposition, just as the communists saw ‘fascist forces’ in JP’s movement.

A clinical dissection of what Anna actually represents and the forces backing him will not, however, divert focus from the growing groundswell against corruption. There is a political space for a credible, even angry, movement against the rot in India’s political system. Circumstances have allowed a venerable, gutsy and untainted outsider to fill the void. It’s the sentiment behind his anointment that is relevant, not the fine print of a law to make India virtuous.