Dealing with Death by T. Vijayendra

8/13/2019 Dealing with Death by T. Vijayendra

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DEALING WITH DEATH

T. VIJAYENDRA

Sangatya

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CONTENTS

Prolonging Death: Capitalism And Old Age

Living Will / Advance Directive

Florence Nightingale

The Blac !ole

"n #emoriam: $itaram $hastr%

&'thanasia( $'icide And $an%asa

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managers -ant people to die ,eore the% can claim their pensions2A e- old people are o co'rse ver% rich and po-er'l* #ost o these are corr'pt politicians and,'siness people* At the other end( there are a e- old people -ho are 8nice+ people( that is( -ise(caring( lova,le and respected* B't the over-helming ma@orit% o old people are ordinar%'n-anted people2

"""* Old Ag is a Ra%&t'

The Medico-industrial complex

Old age is a racet created ,% the medico;ind'strial comple9* This is the second largest ,'sinessater the armament ind'str%* Both control people and nations* The medico ind'strial comple9controls people and nations ,% creating dependencies* 'st as the militar%;ind'strial comple9s'rvives on small;scale contin'o's -arare( the medico;ind'strial comple9 also s'rvives in richpeople having prolonged illnesses( involving e9pensive treatment( ,'t not d%ing* People a,ove3 %ears o age ideall% s'it this p'rpose and the% pa% nearl% > o the medical ,ills* This is ane9's o loot ,et-een the health care s%stem( medical technolog%( dr'g ind'str%( pension andins'rance schemes and ho'sing ind'str%* Britain is an e9ception( -here the National !ealthprovides health services ree at the point o deliver%*

Capitalism s'rvives on individ'alism and insec'rit%* A ear o old age is generated right rom theda% one starts -or* $ocial sec'rit%( pension and ins'rance scheme v'lt'res arrive -ith one+sirst pa% chec* Credit cards( loans or cons'mer d'ra,les and ho'sing loans ollo-* A ,ig ch'no one+s pa% chec vanishes into pension and ins'rance scams* Lovel% media images are createdas to ho- a -ise old man is en@o%ing his old age -ith children and grandchildren2 No- each othese is a -ell;no-n racet* &ver%da% some-here or the other a pension or ins'rance scam is,eing e9posed*

When old age act'all% arrives the pro,lems sho- 'p* The ho'se has to ,e repaired reg'larl%,eca'se the constr'ction is poor* With &ver% ,reaast %o' are s-allo-ing hal a doen pills toeep this or that s%mptom 'nder control* And %o'r pension is not eno'gh*

And as -e said a,ove the old people are 'n-anted( lonel%( 'nhealth%( depressed and 'nhapp%*The% are living in -hat the nat'ralists call 8oo conditions+* For e9ample( in nat're a sparro-lives a,o't . %ears* "n a cage( ho-ever( it can live 'p to 1. %ears2 B't a ,ird in a cage is alsolonel%( 'nhealth%( depressed and 'nhapp%* 'st lie o'r old people2

The abuse of medical ethics

Boos have appeared a,o't ho- rapacio's the dr'g ind'str% is* "rrational tests and s'rgicalproced'res tae a ,ig toll on mone%( health and sometime lie too* !o-ever( it is in the interesto the ind'str% to eep the patient ill ,'t alive*

One o the -orst a,'ses o the health care s%stem is prolonging death* As "van "llich has said(death is deined as the stage -hen the patient is 'na,le to pa%* A ne- c'lt're has come into ,eingsa%ing that lie per se is precio's and that a person has to ,e ept alive no matter ho- m'ch he is

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s'ering or -hether he himsel -ants to live s'ch a lie* $ome time( the converse can also ,etr'e* ecentl%( a man -ith inc'ra,le disease -ent to the Co'rt o !'man ights to mae s'rethat doctors don+t stop lie s'pport s%stems* "n other -ords( he -ants to go on e9isting( even in avegeta,le state* "n this( the religio's organiations( and partic'larl% the Catholic Ch'rch( havepla%ed a po-er'l role* This has led to an enormo's amo'nt o s'ering to the patients and their

amilies* "n man% cases it has also inanciall% ,roen the amilies* On the other hand( millions o%o'ng people are d%ing all over the -orld rom 8c'ra,le+ diseases lie malaria( t',erc'losis(lepros%( cholera and diarrhoea* B't the% cannot pa% and hence the% have to die2

"* A (Nat)*al+ li,'

What is a t%pical nat'ral lieE We @'st have to see a tri,al amil%( -hich is not %et serio'sl%aected ,% 8modern+ lie* p to the age o ive or so the child sta%s near mother and the amil%*#an% children died at child,irth or a e- %ears later i the% -ere -ealings* Then( the childstarts going o't -ith the elders and helps in some activities that helps the amil%* This can ,e

ood gathering( carr%ing and etching* "t is also an apprenticeship* The child learns a lot* B%t-elve %ears s/he starts vent'ring alone or 8gangs+ o children ,egin moving on their o-n(e9ploring( learning and getting to ,e sel;s'icient* B% eighteen( the %o'ng ad'lts start their o-namilies( ,% thirt% all the children are ,orn and ,% the time the% are ort% the% are read% to go2#ost 8old+ people in their orties contin'e to -or till a e- da%s ,eore the% die* The% 's'all%die -ith ver% e- da%s+ illness or none* The ca'ses o death are more 8nat'ral+ and not 8oocondition+ deaths o contemporar% old people* These can ,e h'nger and amine( enco'nters -ith-ild lie( poisono's insects( reptiles( ,acterial and viral disease and accidents*

$'ch a lie does not ace the diseases o o'r time( s'ch as cancer( heart attac( ,acache( dia,etesor even menopa'se* #ost o these occ'r ater 6 and are related to liest%le patterns* Their liec%cles are similar to other living ,eings in nat're* #ost people till the 1=thcent'r% lived this indo lie* ntil ) %ears ago( there -as no pop'lation pro,lem* "n 1( B*C* the pop'lation oh'mans on earth -as less than a million2

Lessons from the past

What -as the ,asis o lie in the pastE One -as that ever%one -as -oring( altho'gh the%-ored m'ch less than -e do* This -as so ,eca'se there -as no leis'red class 4-hich cons'medenormo's reso'rces5 to ,e s'pported( and the nat'ral reso'rce ,ase availa,le -as m'ch higher*Toda% there are h'ge -aste'l ind'stries s'ch as armament( pharmace'ticals( cosmetics( to,acco(alcohol and so on( -hich g'le nat'ral reso'rces* The% also demand h'man la,o'r andcons'merism( all o -hich ca'se m'ch o o'r pro,lems toda%* $econdl%( individ'alism andcons'merism in modern societ% is ,reaing do-n comm'nities* "n the past( the amil% andcomm'nit% provided m'ch o the caring needed in illnesses* Ph%sical la,o'r( revivingcomm'nities and red'cing cons'merism is the main lesson -e can learn rom the past*

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* Li-ing $it! Dignity

Reviving communities/ communities of a new type

To revive comm'nities( irst -e have to 'nderstand -h% comm'nities are ,reaing do-n* The%are ,reaing do-n ,eca'se the old societ% -as 'nree in man% -a%s and c'r,ed people+s

aspirations* No- that cannot ,e reversed* Old t%pe o comm'nities comm'nities have to go2

The driving orces are individ'alism and cash econom%* " %o' have mone% in %o'r pocet %o'are ree to do -hat %o' -ant to do2 No-( individ'alism has come to sta% ,eca'se people cannotgive 'p the reedom the% have achieved* B't dependence on cash econom% and cons'merism can,e red'ced* The need or comm'nit% -ill al-a%s ,e there ,eca'se the h'man species is a socialspecies* What -e need is a ne- t%pe o comm'nit%* A comm'nit% not ,ased on po-er anda'thorit% ,'t on reedom* A ree association o ree people2 "n s'ch a sit'ation the insec'rities-ill ,e less and one can avoid( to a large e9tent( the rapacio's ne9's o medical ind'strialcomple9( ins'rance scams and ho'sing loans*

A rational health care

The rational health care -ill essentiall% ,e ,ased on comm'nit% care* "t -ill ,e ,ased on caringand not leecing* "t -ill ,e ,ased on a health% lie st%le ? a good mi9 o mental and man'alo'tdoor -or( a health% diet and a stress;ree( peace'l tran


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relatives and riends or s'ch sit'ations* &ssentiall%( it ass them not prolong their death -ithmedical intervention or treatment( not to p't them on lie s'pport s%stems and manage their lastho'rs -ith painillers onl%( even i it shortens their lie*

Cultural and eligious Traditions

"n most societies there is a tradition and rit'al o meeting death -ith dignit% and peace* "nessence it is similar to the living -ill* !o-ever( here it is not solel% dependent on individ'al -ill,'t there is a comm'nit% s'pport* The Christian tradition o !ospice comes closest to the living-ill( -here medical care is provided to red'ce s'ering ,'t not to prolong death* $ome !ind's,'ild a cottage ne9t to a hol% river and spend their last da%s peace'll%* ains have a tradition os%stematic asting to death -ith religio's rit'als* $ome tri,es in Fi@i ,elieve that ater death the%-ill live eternall% at the age at -hich the% died* $o the% preer to die in their prime2 "n the polarregion some comm'nities send their old on a ,oat -ith provisions* "t is possi,le to ,'ild sec'lartraditions too* "n !%dera,ad( there is an old;age home r'n ,% the Comm'nist Part%2

ADD L!FE T" #"$ #EA% A&D &"T #EA% T" #"$ L!FE'

P',lished in Calc'tta(Frontier( 'ne )3( )6 also inMedico Friends Circle Bulletin( Octo,er()6*


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LIVING WILL / ADVANCE DIRECTIVE

TO #G FA#"LG( #G P!G$"C"AN AND ALL OT!& P&$ON$ CONC&N&D T!"$D"&CT"& is made ,% meHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH

HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH at a time -hen " am o so'nd mind andater care'l consideration*

" D&CLA& that i at an% time the ollo-ing circ'mstances e9ist( namel%:

" s'er rom one or more o the conditions mentioned in the sched'leI and

" have ,ecome 'na,le to participate eectivel% in decisions a,o't m% medical careI and

T-o independent ph%sicians 4one a cons'ltant5 are o the opinion that " am 'nliel% to recoverrom illness or impairment involving severe distress or incapacit% or rational e9istence*

T!&N AND "N T!O$& C"C#$TANC&$ m% directions are as ollo-s:

"* That " am not to ,e s',@ected to an% medical intervention or treatment aimed at prolongingor s'staining m% lieI

""* That " am not to ,e p't on an% lie;s'pport s%stemsI

"""* That an% distressing s%mptoms 4incl'ding an% ca'sed ,% lac o ood or l'id5 are to ,e'll% controlled ,% appropriate analgesic or other treatment( even tho'gh that treatment ma% shorten m%lie*

" consent to an%thing proposed to ,e done or omitted in compliance -ith the directions e9pressed a,oveand a,solve m% medical attendants rom an% civil lia,ilit% arising o't o s'ch acts or omissions*

" -ish it to ,e 'nderstood that " ear degeneration and indignit% ar more than " ear death* " as m%medical attendants to ,ear this statement in mind -hen considering -hat m% intentions -o'ld ,e in an%

'ncertain sit'ation*

" &$&& the right to revoe this D"&CT"& at an% time( ,'t 'nless " do so it sho'ld ,e taen torepresent m% contin'ing directions*

$C!&DL&

A Advanced disseminated malignant disease

B $evere imm'ne deicienc%

C Advanced degenerative disease o the nervo's s%stem and/or m'sc'lar s%stems -ithsevere limitations o independent mo,ilit% and 'nsatisactor% response to treatment

D $evere and lasting ,rain damage d'e to accident( in@'r%( stroe( disease or other ca'se& Other conditions o compara,le gravit%*

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0LORENCE NIGHTINGALE

On $at'rda% Nora got a call rom the !ospice centre* Bertha Cascellino -as asing or her* Normall%Nora -ent on T'esda%s and Frida%s and that too onl% on night d'ties*

The &verest esort or Pain and Palliative Care also -ored as !ospice 4centre or care o terminall%

ill persons5* !er riends -ere al-a%s maing 'n o the -ord J&verestJ ? ever;rest or rest orever2

"t -as sit'ated on the o'tsirts o Bilgram and -as close to the Bilgram eserve Forest* Nora o'nd itconvenient to visit it on her -a% ,ac rom the orest*

The &verest esort -as headed ,% $r* Cecilia* $he -as a grad'ate in !olistic !ealth rom the #edical#ission $isters* $he -as also a competent n'rse and a good administrator* Kloria( 'lia and osephinehelped -ith vario's tass ? rom cleaning to cooing* A'nt $'san( a ,'9om old lad% -as the matron*ohn Pinto and his dog onn% looed ater the garden and sec'rit%* The% moved a,o't and -eregenerall% lied ,% ever%one*

The% had a cons'ltant ph%sician ; Dr* Asha% -ho had recentl% come ,ac rom the *$*A* -ith allsorts o degrees in pain and palliative care* !e also had a h'ge ed'cation loan( nearl% thirt% lahr'pees( to pa% ,ac* !e had long hair( ear rings and -as more interested in -oring as a D* * inBilgram Cl', than -oring at the esort*

The &verest esort had t-o sections and t-o inds o patients* The irst ind -ere those -ho -ere richand had all sorts o pain d'e to their lie st%le* The% -ere given a co'rse in Basic !olistic !ealth andhad good health% ood( %oga( -als in the orest( -or in the esort garden and -ent to listen to #'sicat the Bilgram Cl',* The% lived in the section 's'all% reerred to as the esort*

The esort had an e


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environment and nat're* Nora too the sessions on &nvironment A-areness in Basic holistic !ealthCo'rse and led them to orest -als* $he ta'ght them that reconnecting -ith nat're has a therape'ticrole* $he enco'raged them to -or at the garden -ith ohnJs help and do some home gardening -henthe% -ent ,ac* $he had a tremendo's sense o h'mo'r and la'ghed easil% at the @oes people tell her*!er patients looed or-ard to her visits*

Nora had also ac


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red'ce s'ering and not prolong death* We help o'r patients to die in peace and tran


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oten came on $at'rda%s* Toda% Bertha had also called her ,aner and he had arrive -ith a large#anila envelope and let ater a chat and his 's'al glass o sherr%*

Dr* Asha% also had a ,'s% sched'le ,eca'se $at'rda% evenings at the Cl', -as al-a%s demanding* !einished his co'nselling sessions and -ent on his ro'nd to the hospice* A'nt Bertha -elcomed him ,'tcomplained o lac o sleep* Asha% said O** !e -ill change her medicine ,'t on one condition* $he

sho'ld not have a drin* Bertha said ine and po'red the $herr% onl% or him* Asha% said JKood girlJpatted her on her chee and -as o* !e peeped in at $r* Cecilia room and sa- she had visitors so hesaid JB%e2 " -ill see %o' on #onda%J*

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$o in the evening -hen Nora got her call she agreed to drop in* Bertha A'nt% -elcomed her said shehad a lot to tell her and $r* Cecilia* $he said( JNora dear2 " donJt have long to live* $o toda% " calledCecil rom the ,an and arranged ever%thing* "n the #anila envelope there are pacets or %o'(Asha%( Cecilia( Kloria( 'lia( osephine( A'nt $'san and ohn Pinto* There is also something in m%-ill or %o'* Changing the -ill ma% tae too m'ch time so " -ant to tell %o' that share it -ith Asha%*The ,o% has ,een ver% good to me and he has his loan to pa%* " thin %o' -ill ,e a,le to pa% it oJ*Nora a got ,it alarmed and called $r* Cecilia* Cecilia said donJt -orr% she told me all this several times*$he is ver% ond o %o' and she eels that she m'st do something or Asha%* Bertha gave the envelopeto Cecilia or sae eeping in the oice sae*

Cecilia came ,ac ater locing the sae* Then Bertha said( JAnd no- let 's have a part%2J And as i onc'e a tempo trolle% stopped o'tside and in -aled a co'ple o ,earers rom the Bilgram Cl', carr%ing-hite ,o9es o ood* "t -as mainl% things to go -ith a part% ? pra-ns( ish tia( small sa'sages(chicen manch'ria( go,i manch'ria( cheese dip and ,read stics and so on* Bertha said that the% canhave all the drins in the -ine c'p ,oard* Nora and Bertha st'c to some old French -ine* The girlspolished o red -ine ,ottles( ohn and $'san -ent or -his% -hereas Cecilia -as happ% -ith her ginand lime* The% pla%ed some m'sic and sang* ohn did some pantomime o some o the rich visitors othe esort* Nora told @oes* There -as m'ch la'ghter* onn% -anted to ,e part o ever%thing and cats-ere pro-ling or tit ,its* &ver%,od% had a good time*

The part% ended as all god things m'st do* Nora prepared her pillo- on the eas% chair and ,ro'ght o'ta vol'me o Pro'stJs la recherche du temps perdu48"n $earch o Lost Time+5* The hospice -ent


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time the other ,rother and sister -ill ,e a,le to reach* The% ordered the porta,le rerigerated hearse in-hich the ,od% can ,e preserved* The% -aited till o'r ,eore calling 'p Dr* Asha% ,eca'se the%tho'ght he -o'ld ,e sleeping late*

Ater several rings Asha% replied* Nora ased( Mcan %o' come to the hospiceEJ

JWhat is 'pE " am in Bangalore* #% riend rom A'stralia has come and so " too the night ,'s*J

JBertha A'nt% passed a-a% earl% this morning* $he sort o ne- it -as coming and she prepared or it*!er ,aner had come d'ring the da%* And in the night she especiall% called me and told Cecilia and mea,o't her last -ishes* Then -e had a part% and -e almost inished her ,ar2 4la'ghs5* Bertha had severalglasses o her ,est -hite -ine*J

There -as a prolonged silence on the line*

JAre %o' still thereEJ

JGes2 " am s'rprised and not s'rprised* An%-a% she -ent happil%J*

JThat is -hat " eep on telling m%sel* B't " canJt eep m% tears ,ac* $he has ,een lie a mother to meor the last so man% %earsJ*

J" too am eeling sad* Tae care* " -ill come ,ac in a da% or t-o*J

Go' can tae %o'r time* The 'neral is on $'nda%J11111

"t -as a ver% ,ea'ti'l 'neral* Bertha -as pop'lar and so man% old people came rom all over theto-n( some even speaing Port'g'ese2 The la-%er read the -ill on #onda% at the hospice* The -holeamil% and Nora and Cecilia -ere present* "t said( J " have onl% one propert%( the ho'se at No* 6 cavalr%oad* #% children are -ell settled and are genero's o heart* For nearl% . %ears " have treated Nora asm% da'ghter and she has reciprocated the eeling* $o " give m% ho'se and all its contents to Nora* #%children( ho-ever( are -elcome to pic 'p an% memento rom the ho'se*J

&ver% one appla'ded* Nora looed apprehensivel% at the amil%* The% -ere all ,eaming and came andh'gged Nora* The% said( JWe are so glad that #'m did -hat she did* We all -anted to help %o' ,'ttho'ght %o' -o'ld ,e oended*J Nora co'ld not stop ,a-ling* &ver% one soothed her sa%ing( JNo-2No-2 Go' sho'ld ,e happ%* All %o'r inancial -orries are over2J

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Nora sold the ho'se or s* One crore since it -as prime propert%* $he gave .. lahs to Asha%*Asha% -as rel'ctant to tae it ,'t Cecilia prevailed 'pon him sa%ing that she hersel -as present -henBertha e9pressed her -ish to pa% o his ed'cational loans* Nora sent her o-n son to &ngland to do adoctoral co'rse in environment sciences* With the remaining mone% she ,o'ght a nice propert%,et-een the orest and the hospice*

)* 1* )11

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THE 2LAC3 HOLE

There is but one truly serious philosophical problem, that is suicide !udging whether life is worthliving or is not worth living amounts to answering the fundamental "uestion of philosophy

#lbert CamusThe Myth of $isyphus

Art'r Baaev -as travelling in the West !imala%as in Nepal* !e had heard o an area called JThe Blac!oleJ and the legend that no one ret'rns alive rom it* !e -as c'rio's and as the sa%ing goes( c'riosit%illed the cat*

Asing ever% -here he inall% reached a small hamlet called Pos'ng and there he -as* Ges( The Blac!ole does e9ist and it is across the river ,'t no one rom the village -as prepared to tae him there*When ased i an% one ,eore him had come( the% readil% ans-ered( %es( %es( several -hite men hadgone there ,'t no one ret'rned*

Art'r -as reading Cam's and said to himsel( -hat the hell2 " might as -ell ind o't i lie is -orthliving or not* $o he too a small ,oat and crossed the river* The villagers told him -here to start and-here ,est to land* !e o'nd a small oot path leading 'p the hills* With his heart in his hand he slo-l%proceeded* "t -as a sort o lane -hich t-isted and t'rned ever% e- h'ndred meters -ith ,'shes allaro'nd* $


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order on their ta,le -itho't 'ttering a -ord*

!annah said( JGo' m'st ,e d%ing to as some


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the la'ndr% ,aset( had a ,ath( got into the p%@ama s'it and cra-led ,et-een sheets*

!e -oe 'p rereshed aro'nd 1 pm( got into his trac s'it and -ent do-n to the l'nch area* !e heardsomeone speaing Kerman and @oined him or l'nch* !e st'c to his A'g'stina ,eer altho'gh a lot ochoice -as availa,le* !e had some ish( some -hite -ine and apple pie and three varieties o cheese*

!is companion -as a portl% looing e9 ,aner -ith a -alr's mo'stache* Over coee he told his stor%o coming to the Freeland* !e -as health% ,'t -as


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The ne9t three months -ere ver% ,'s% or Art'r* !e -ored or 6 da%s a -ee or hal the da% invario's pro@ects o Freeland -hich made it sel s'icient in ood and energ%* !e also spent some timeat the indergarten* T-ice a -ee he spent st'd%ing e'thanasia and interacting -ith people -ho -eresta%ing at &ver est and -ho in their o-n -a% -ere also st'd%ing e'thanasia*

The three months le- ,%* !e had come in an'ar% and no- it -as April* Then one da% 'th( one o

the residents o &ver est ased him i he -o'ld ,e the host at her Last Fling on Kood Frida%2 Art'r-as thrilled ,'t he said he had to get the approval rom Freeland management* $he said she had alread%ased them and the% said it -as alright*

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Frida%( the 1.thApril( )1) remained etched in Art'rJs memor% orever* 'th -as 66 %ears old and shehad le'aemia or ,lood cancer* $he -as a ,iochemist and had held a proessorJs @o, at the #a9 Planc"nstit'te* At the age o 6 -hen she discovered she had cancer she retired rom her @o, on medicalgro'nds and had a good pension*

'th -as a Kerman e- o 'ssian origin* !o-ever( her parents had ,ecome Christians and shecarried a m'lti religio's( m'lti ethnic and m'lti ling'al c'lt're* $he -as active in peace movement( inanti n'clear movement and in !'manist Atheist movements* $he -as th's a c'rio's mi9 o rationalismand rich c'lt'ral ,acgro'nd*

'th had ,een sta%ing longest at &ver est* Not ,eca'se she had an% misgivings a,o't e'thanasia* B'tall her actions -ere deli,erate* $he -anted to en@o% lie as long as she co'ld and then decide to end it-hen it -as not -orth living an% more* $he chose her date and her host -ith care and had a reason orever%thing*

$o on April 1.( )1)( Art'r -as read% earl% morning in a trac s'it to accompan% her to the $'nrisepoint on the &astern #o'ntain* Ater the glorio's s'nrise the% ,reaasted on orange @'ice( ,lac coeeand 'ssian ,lac ,read and some cheese*

$he rested most o the da% and had a r'gal l'nch -ith some ish so'p and -aers and a pint oA'g'stina*

"n the evening Art'r -as read% in a ,lac s'it to accompan% her to the $'nset point in the Western#o'ntain* The% remained seated


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Li


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"bituar(

IN 4E4ORIA4 SITARA4 SHASTRY

$itaram $hastr% died on )7 Oct )1)( -hen he -aled into a r'nning train ,et-een Adit%ap'r andKamaria stations near amshedp'r* The incident occ'rred at a point -here the train crosses a ,ridge

over a river thirt% eet ,elo-* !is ,od% -as thro-n o the ,ridge( and la% on the ,ans o the calml%lo-ing river* !e -as a,o't . %ears old*

A -ee earlier( he had ,een diagnosed as having throat cancer* !is da'ghter anti Pra,ha 4Chin'5 andher h's,and had come do-n to amshedp'r rom Delhi in order to tae him ,ac to Delhi ortreatment* On the da% the% -ere s'pposed to l% o't( he let home earl% in the morning and did notret'rn* When contacted on his mo,ile phone( he replied that he -o'ld not ret'rn and that the% sho'ldnot search or him* Then he s-itched o his phone*

From 1=30 on-ards( till the da% o his death( $itaram -as a 'll;time revol'tionar%/social activist* Till1=30 he had -ored or the L"C in amshedp'r and -as a 'nion leader* That %ear( lie man% other

places in "ndia( a lot o %o'ng people t'rned to-ards the path o social revol'tion* "n amshedp'r


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er% oten $itaram came across as a diic'lt person* " thin the main reason -as that he -as impatientand 'nhapp% -ith 's or not ,eing active eno'gh( not 'nderstanding the need to align -ith othermovements lie the harhand movement or -ith the %o'th coming o't o the P movement( and lastl%not 'nderstanding the need to s'pport each other( not living in comm'nes* !o-ever he -as respectedand loved ,% a ver% large n'm,er o people* !'ndreds o comrades and riends received his 4andNaliniJs( his -ie5 hospitalit%( help and advice* !e -ill ,e missed ,% a large n'm,er o people*

!ere -e m'st also to'ch 'pon NaliniJs role in his lie ; she held him -hole thro'gh all the noise andt'rmoil o his lie( despite all their @hagras 4domestic


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E5THANASIA6 S5ICIDE AND SANYASA

" tho'ght ,% -riting an o,it'ar% o Comrade $itaram $hastr% " had come to term -ith his death* B't it-as not so* $ome correspondence -ith riends and comrades made me realise that there are iss'es thathave never ,een ade


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A ver% large n'm,er o old people -ish death ,eca'se lie is 'n,eara,le* "t ma% ,e d'e to ill health orinancial reasons or ,oth* The main reason or it is that in the present societ% individ'alism and n'clearamil% is the accepted val'e s%stem and inter generational care is vanishing ast* $ome o the oldpeople also commit s'icide ,eca'se the% -ant to die -hen the% are still a,le to move a,o't on theiro-n* &ven i e'thanasia -ere legal the% ma% not


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B't there is also a actor o ear o ,eing s'ed ,% the rich patient+s amil% or not saving the lie o thepatient*

D"%t"*7s DilmmaWe have at several places a,ove criticised the health proession* B't individ'al doctors do acedilemma* The% are a part o a societ% and a medical s%stem and their o-n opinions have oten needed

to ,e modiied or compromised d'e to vario's actors mentioned a,ove* $till there are good hospitalsand good doctors -ho gen'inel% help the patients in ever% -a% incl'ding pain and palliative care andpassive e'thanasia*

Sanyasa and P*pa*ing ,"* Dat!The val'e s%stem Jthat lie m'st ,e saved all costsJ is o,vio'sl% at a'lt* $everal actors o cons'mersociet% are responsi,le or it* The perception that mone% can ,'% an%thing( partic'larl% the J,estJ healthcare( that it can Jsnatch lie ,ac rom the @a-s o deathJ( the greed o the medical proession( 4altho'ghman% good doctors do not s',scri,e to it5 and peer press're* "t has ,ecome sociall% accepted so thateven poor amilies are 'nder press're to accept it and go thro'gh enormo's ps%chological and inancialstress*

This -as not al-a%s so* "n most societies there is a tradition and rit'al o meeting death -ith dignit%and peace* "n the Christian tradition o !ospice medical care is provided to red'ce s'ering ,'t not toprolong death* The !ind' tradition ,elieves that ater death the so'l has to attain 8#osha+ 4reedom5and or that it has to c't itsel rom 8#a%a+ 4,ondage to earthl% ties o material -ealth and h'manrelationships5* To this end some !ind's ,'ild a cottage ne9t to a hol% river and spend their last da%speace'll%* $ome tae 8san%asa+ 4ren'nciation5( leave amil% and die among 'nno-n people* ainshave a tradition o JsallahanaJ ; s%stematic asting to death -ith religio's rit'als* $ome tri,es in Fi@i,elieve that ater death the% -ill live eternall% at the age at -hich the% died* $o the% preer to die intheir prime2 "n the polar region some comm'nities send their old on a ,oat -ith provisions* "t ispossi,le to ,'ild sec'lar traditions too* "n !%dera,ad( there is an old;age home r'n ,% the Comm'nistPart%2 There are several sec'lar old age homes in the co'ntr%* !o- " -ish $itaram had a choice liethis2 B't that -as not to ,e*

S" t!n#

What one -o'ld do i one aces a similar sit'ation in oneJs o-n lieE " thin all choices are open andthe person has to choose according to the sit'ation* " palliative care is not availa,le or the person-ants to do die -ith a air command on his/her ac'lties( does not -ant to ,e ,ed ridden etc* thens'icide ,ecomes a valid choice* The pro,lem -ith s'icide is that it involves violence ? not @'st to-ardsonesel ,'t to-ards oneJs amil% and riends* &ven strangers can ,e aected ,% it as in the case os'icide 'nder a r'nning rail-a% train* An engine drive told me that these cases aect them or a %ear atleast2

One can opt or some ind o 8san%asa+ preera,l% -ith the no-ledge o the amil%( so that amil% isnot stressed* One need not ,e religio's to do it* Then one can -al a-a% and die among 'nno-npeople in an% manner one chooses on a date and time o oneJs o-n choice* Preera,l% it sho'ld not ,ein a violent manner so as not to h'rt even 'nno-n people* $'ch a choice( ho-ever( re


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Dealing with Death by T. Vijayendra

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