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The Courage to Speak: Ethics and Elderhood
posted 05.25.2016

By Peter Whitehouse

The greatest challenge to elders is not ageism, it is dysfunction in our political, ecological and economic systems. The deterioration of our democratic processes, the crisis of climate change and the injustice of income disparities reflect broad organizational and cultural disarray in the United States and other parts of the world. These challenges are linked to the accumulation of power by those who have monetized politics, misused natural resources and manipulated financial systems for the gain of a small group of increasingly wealthy people. These oligarchs are oriented to the short term, the next quarter and the accumulation of material wealth.

The opportunity, in fact the moral obligation for elders, is to speak truth to this power in a way that re-dresses the species-threatening behaviors that contribute to human suffering and the extinction of other living creatures. We need not only to speak and act up courageously, but also to do so in a way that contributes to positive changes in human consciousness and the world around us.

Ethical Issues Around Cognition

But will change come through revolution or evolution, through conflict or compromise, or through a complex combination of all four? It is only through collective wisdom and action that necessary change will occur. One of our biggest intellectual shortcomings is our frequent failure to recognize the limits of our thinking abilities, even if we are considered “normal,” or “intelligent.” Humility is an essential part of wisdom, individually and culturally.

One of our biggest existential and social concerns is the loss of cognitive abilities as we age. Functionally important loss of memory and other thinking abilities, i.e., dementia, has been reported for as long as we have been recording history. But in modern times we have made this problem almost exclusively a medical and scientific problem to solve. In the United States, the Alzheimer’s empire of lay organizations, government agencies and industrial concerns are promising a cure and suggesting specific targets for it, such as the year 2025, as well as associated price tags. They imagine magic bullets and even, as in a recent report Changing the Trajectory of Alzheimer’s Disease, a model in which such a drug would be free. They create individual and collective fear, demand the further investment of money and pay too little attention to the care of those now affected, or of those who will be affected tomorrow. Fame and fortune too often are the goals of unskeptical scientism and unbridled capitalism.

Certainly research and scholarship are a necessary part of a balanced social approach, but perseverating failed approaches and exaggerating expectations are not. Claims that we will find a cure for dementia are irresponsible, both logically (because dementia is caused by many, often mixed factors) and practically (because doctors may be confused about what they are trying to treat—for example, the label Alzheimer’s actually includes a set of heterogeneous conditions difficult to differentiate from aging processes).

Sometimes the declaration that “more research is needed” is not, in fact, true, and practical wisdom should prevail. A pill will not cure dementia associated with head injuries, but wearing a helmet or avoiding interpersonal physical conflict might.

Public health approaches seem to be on the rise, as they should be in an era when weather patterns, poverty and political warfare are decimating the health of individuals, communities and ecosystems. But there is not much medical and pharmaceutical profit to be made by improving the common good through a healthier diet, more exercise and bettering the quality of community.

Forward-Thinking Strategies for Humankind

If asked to pick a single cultural process to improve human brain aging and health, for me it would not be increased payments for high-tech unproven medical approaches like biologics and biomarkers. In my view, the one thing that would most dramatically contribute to human flourishing and the likelihood of species survival would be to improve the education of children, through a collective commitment to public education.

But school systems around the world are in shambles, materially and morally. Through sharing their experiences and wisdom, elders could enhance the education of children and also benefit themselves. As the cofounder of three intergenerational public schools in Cleveland, president of Intergenerational Schools International and a professor in two universities, my purpose in life is to innovate educationally and organizationally to enhance collective wisdom.

Yet in efforts to enhance the education of our future elders (i.e., children), some of the same malignant forces are at work that distort our efforts to aid elders with memory problems. This is particularly ironic because preventing health problems in elders should start at a young age. Moreover, to ensure viable societies that can care for elders, we should educate our youth. But in my world, sometimes well-meaning (but often self-centered) business people believe they have found the way to improve public education, or at least produce more proficient test takers and productive workers.

Replacing existing public school systems with perhaps marginally better schools might contribute to better test scores, but not to better citizens. The application of business approaches in nonprofit public schools is fraught with difficulties, particularly when improving educational outcomes depends on demonstrating material success. Efficiency is good, but not at the cost of learning failures. Privatization of political influence is sought, marketing efforts emphasize promises over successes and the true spirit of innovation in public education is squelched. Breakdowns, not breakthroughs are the result. Similarly, the privatization of higher education largely has been a disaster as profits are made, but educational goals are not met. And efforts to improve children’s, young adults’ and elders’ brains by addressing environmental toxics like lead, mercury, pesticides, etc., altering diet, and creating opportunities for being physically and intellectually engaged are minimized.

Responding to the needs of older people with memory problems and improving education for children are essentially the same problem. They are matters of what we now tend to call brain health, or by the less biologically oriented term, cognitive health. Yet the current emphasis on solving these challenges in society often are self-serving claims from the position of the moral high ground that offer a false hope, like promising to cure dementia or fix education solely with more funding without open-minded intergenerative innovation.

True hope is to recognize that developing an organization or a nation happens through more than just economics, and that the concept of personal and social wealth must be broadened beyond the monetary.

The essential tool to address these challenges is organizational. How can we reimagine and create organizations that reflect not the worst of human ambition and narcissism, but the best of an ever-evolving human consciousness? How can we speak courageously and ethically to current leaders in ways that will influence their minds and hearts, and not just alienate them and risk being discounted?

Peter Whitehouse, M.D., Ph.D., is professor of Neurology and current or former professor of Psychiatry, Neuroscience, Psychology, Cognitive Science, Bioethics, Nursing, History and Organizational Behavior, at Case Western Reserve University and professor of Medicine at the University of Toronto in Shaker Heights, Ohio. He also is the President of Intergenerational Schools International.

Editor’s Note: This article appears in the May/June 2016 issue of Aging Today, ASA’s bi-monthly newspaper covering issues in aging research, practice and policy. ASA members receive Aging Today as a member benefit; non-members may purchase subscriptions at our online store or Join ASA.

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