In the January 2006 edition of Commentary, bioethicists Eric Cohen and Leon R. Kass offer a compelling essay on the challenge represented by millions of the aged among us. In "Cast Me Not Off in Old Age," they warn that we are now witnessing the development of a "mass geriatric society" which will present this country with massive economic, social, medical, political, and ethical challenges.

Recognizing that, many Americans argue that there must be some better way to confront these challenges, and all too many appear willing to redefine human dignity in terms of quality of life, autonomous choice, and the competing interests of generations.

Indeed, some are ready to argue for a "duty to die" that assumes a responsibility for the elderly to get out of the way. Far more are ready to assume that the death of the elderly is at least preferable to long-term debility and decline. Both of these assumptions run into direct conflict with the Christian worldview and the Bible's teachings regarding reverence for life and respect for the aged. Confronting these assumptions will require Christian courage as well as keen Christian thinking. This challenge will not wait.

In light of these challenges, Cohen and Kass suggest two false "solutions" that may appeal today to Americans who take opposing sides on these issues.

First, the authors dismiss the argument that the problems of old age can simply be solved by medical technology. They cite Dr. Mark B. McClellan, the top official at the Centers for Medicare and Medicaid Services, who claimed last July that "Medicare can do so much more than give you dignity in old age." Dr. McClellan claimed that Medicare can actually extend life, improve health, and save money by preventing and curing the diseases of old age.

Cohen and Kass dismiss this as "the medical gospel of healthy aging." While accepting that persons can do much to make themselves healthier and to extend active and vigorous life, Cohen and Kass understand that life itself, even with medical treatments, involves limitations. It is foolish, they suggest, "to act and speak as if medical progress (whether in prevention or in cure) will liberate us from the realities of decline, debility, and death or from the unavoidable duties of caregiving at the end of life." The authors insist that the paradox in modern aging is this: we are vigorous longer and we are incapacitated longer.

Most tellingly, Cohen and Kass criticize much of the propaganda about old age now commonly advertised in our society. "Finally," they note, "there is something weird about treating old age as a time of life when things should always be 'getting better.' While aging affords some people new possibilities for learning and 'growth,' it also means--eventually and inevitably--the loss of one's vital powers. Some people may ride horses or climb mountains into their seventies and eighties, just like in the commercials for anti-arthritis medication, but such idealized images offer a partial and misleading picture of the realities of senescence, that series of small dyings on the way to death."