Age-old question: At what age does a life become worthless?

While we may show respect for the elderly, that respect comes from a place in Irish society where older people are pushed to the margins, says Sabina Brennan.

IMAGINE for a moment that you are an emergency room doctor. Think ER rather than A+E. Paramedics burst through double doors presenting you with two patients. 

Both have serious gunshot wounds. Both will die without immediate treatment. You can save only one. One is 27, the other is 87.

Who will you save?

Chances are you will choose to save the 27-year-old. It’s a tough decision, but not too tough, right? 

After all, the 87-year-old has had a good innings and the 27-year-old has their whole life ahead of them. 

The 87-year-old will die pretty soon anyway.

I’ve presented this dilemma many times to older audiences and without fail almost everyone, including the 87-year olds, choose to save the 27-year old.

Now, consider the same dilemma, but this time you have to decide between a black person or a white person I’m guessing that you’ll say, I can’t make that decision. I’m not racist.

Dr Sabina Brennan. Co-Director, NEIL Dementia Research Programme.

Ok. So rewind the film — the doors burst open, this time you have to choose between a woman and a man. Who will you save? I’m guessing you’re not sexist either.

How about a 27-year old and a 57-year old? Who will you save? 

A 27-year old and a 37-year old? Who will you choose?

At what age does my life become worthless? At what age do you think to ask other pertinent questions that might inform your decision. 

On average, a 27-year old will have a better chance of survival than an 87-year old, but not all 87-year olds are the same, no more than all 27-year olds are the same. 

What if the 27-year old has a terminal disease and the 87-year old is fit and healthy? It’s alarming how comfortable we are with allowing rights to diminish with increasing age.

Ok, I’ll admit that my ER scenario is simplistic but it is effective in demonstrating how inherently ageist we are. It is shockingly easy for us to make life and death decisions knowing nothing more than a person’s age.

Sure that’s just a hypothetical. What about real life? 

Well, according to a 2012 study, older adults are less likely to be given the same medical treatment as younger adults, even when it would likely be effective.

The Irish Longitudinal Study of Ageing highlights alarming under treatment of treatable conditions in Ireland’s over-50s. For example, only 30% of older people with depressive symptoms are prescribed appropriate medical therapy for depression.

While we generally respect our elders in Ireland, most of the time that respect comes from a place of ‘othering’, a well-meaning place, but a place that nonetheless denies diversity and lumps all older people together as frail and dependent — ‘the elderly’ — who deserve the respect of the public. Reach 70, and that perfunctionary respect might get you the offer of a seat on a bus.

However, when it comes to heart surgery it turns out that 63% of respondents will give heart surgery to a younger man before you, even though both of you have been on the waiting list for the same amount of time and both of you are equally in need of a bypass.

Older people don’t deserve more or less respect. They deserve to be treated equally. They deserve to enjoy the same rights as everyone else.

Ageism is a major barrier to the realisation of the human rights of older adults in Ireland. 

Older adults are members of the general public and should not be marginalised, excluded, or consigned to the appendices of policy documents.

Unfortunately the right to health and personal social services is not defined in Irish legislation.

Now, I want you to imagine for a moment that by some miracle you managed to save both the 27-year old and the 87-year old. Both are recovering well, both are continent but both need assistance to the bathroom.

You lack the resources to provide this basic service. Who do you bring to the bathroom? Who do you place in incontinence wear? 

Sadly this isn’t a hypothetical situation and many older adults suffer the indignity of being forced to wear nappies simply because they aren’t mobile.

Mary Rogan, who runs a practice in Galway, said she was aware of many cases where older people sent to hospital for treatment were put in nappies because there were insuf?cient nursing staff or carers to escort them to the toilet.

“This results in these patients developing incontinence, because of this practice,” Dr Rogan said.

Ageism can affect anyone at anytime in their life. It is the most commonly experienced form of prejudice affecting people of all ages. 

The main source of age discrimination against older adults are young people, governments, healthcare systems and healthcare professionals. 

Ageism is so pervasive that it is easy to adopt negative self-perceptions as we grow older.

Calling out ageism is not political correctness gone mad. 

Over-50s with more positive perceptions of ageing actually live seven and a half years longer than those with negative self-perceptions of ageing.

Older adults exposed to positive stereotypes have significantly better memory, whereas negative self-perceptions contribute to worse memory and feelings of worthlessness.

Ageism impacts on our health, healthcare and the treatment that we are afforded. Equality should not decrease with increasing age, no more than it should decrease with increasing skin pigment. 

We need to take action now, we need to call out ageism when we encounter it.

Sabina Brennan is co-director of the Neuro-Enhancement for Independent Lives (NEIL) research programme at Trinity College

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