The Engineered Death

How technology complicates the end of life

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This is not only a parable about technology and progress. This is also a true story.

When I was a boy, my mother contracted an incurable cancer called Hodgkin’s disease. At a hospital in Manhattan, in New York City, ingenious medical engineers and doctors bombarded her with radiation—at far higher levels, and for far longer, than most experts at that time recommended.

Only my father knew of the severity of her illness. My mother kept that from others. I began to grasp the situation when our grandmother came to care for my brother, sister, and me while my mother stayed in the hospital. Through the prism of my 10-year-old mind, I concluded that something terrible had happened for us to endure Grandma’s strange cooking and hot temper.

To our family’s delight, our mother’s disease vanished. She remained cancer-free. In time, she could say aloud that in the mid-1960s she was among the first Hodgkin’s patients to be cured in the United States. She could also describe her anxious encounters with the bulky and fearsome radiation equipment that, guided by her innovative doctors, had saved her life.

My mother’s youthful experience turned her into a lifelong adherent of the secular faith in innovation. Fifty years later, her faith was undiminished. “Obey your doctors,” she often told me. “You get the best results.”

This past July, I recalled my mother’s creed as I sat at her feet in the intensive care unit of a Long Island, N.Y., hospital. Her 84-year-old lungs, burdened by a weakening heart, had failed. She could breathe only with the aid of a ventilator. She couldn’t speak.

A specialist directed the computer-controlled ventilator as if he were playing a video game. The software was graphical, and the numerical levels were displayed in large type on a big screen. With a few keystrokes, the specialist could deliver more or less oxygen.

All of us have faith in the idea of progress—that life gets better. And most of us believe new technologies are the best indicators of progress. We believe, in short, that innovation and human improvement are one and the same. Take away the ventilator and my mother dies. Build a better ventilator and then, perhaps, she lives.

Our lives are dominated by digital technologies. Observing my mother, I became acutely aware that our deaths are also computer mediated.

My mom isn’t welcoming death. She indicates through dramatic hand gestures and facial expressions that she wants doctors to keep trying to save her.

For how long, I wonder? Today is her 31st day on a ventilator. The doctors want, in their lingo, “to wean her off.” Yet when they try, she struggles to breathe, her heart rate rises steadily, and the attempts are abandoned.

The doctors are doing everything they can, but what if they can’t fix my mother? What if, as her CAT scan suggests, the radiation treatments that cured her of cancer also scarred her lungs so badly that now they won’t work?

Unintended consequences are common features of our engineered lives. Why Things Bite Back: Technology and the Revenge of Unintended Consequences (1996) is historian Edward Tenner’s explanation of the situation. I suspect everyone would accept the deal my mother got: 50 years of healthy life in exchange for a few months of extreme suffering. But I can’t help but ask now, how many more bites can my mother endure?

I don’t know when faith in technology and progress gives way to another kind of faith. Having devoted our lives to better living through engineering, when do we surrender to whatever lies outside the reach of our machines?

About the author

G. Pascal Zachary is a professor of practice at Arizona State University and author of Endless Frontier: Vannevar Bush, Engineer of the American Century (MIT Press, 1999). His mother, Rosalyn, died on 1 August.

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