Adam Steiner discusses his contribution to a new guide to the Snap Election, considering the political and philosophical importance of the NHS.

The majority of humans have always accepted that the right to life often precludes the right to death; that like time, life follows a linear path and that the two states of being and/or nothingness are diametrically opposed – I would like to reconsider this position and posit an argument for post-life existences that transcend traditional perspectives on the individual’s absolute right over their own state of being.

I recently wrote an essay on the implications for the National Health Service in the face of the coming UK General Election on June 8 as part on an anthology, TACTICAL READING: A SNAPPY GUIDE TO THE SNAP ELECTION 2017, put together with impressive speed by Eyewear Publishing. I talked about the undercutting of public spending in to the service, and how the current government’s strategy could be construed as a purposeful attempt to dismantle the strongest arm of the welfare state.

Towards the end of that article, I reached the classical endgame of any discussion about healthcare provision, the duty of care and the limits of authority in switching-off life support, treating people who have stipulated a do-not-resuscitate order – set against the grey dawn – of an ageing population. The political implications of this are huge, with older voters being more likely to vote in general and in accordance with their established party allegiances because they represent, for them, a certain system of political beliefs, which may no longer be valid. Set this against the youth vote; students, young people not in education, and more or less anyone feels alienated by the establishment and political system in general – along with the reluctance of the current Conservative government to grant voting rights to young people aged 16; who are allowed to drive a car or join the armed forces.


The dichotomy of age, young into old, is a chronological trap, that limits and restricts our ideas of dying, and how and when this “should” or “could” occur. There are several philosophical and physics based arguments to say time is straight as an arrow/non-linear/a trapezium, but forget the funky shapes for a second. Age is incremental, at least in terms of revolutions around the sun, granting us a year, we can chart the number of times we have done so, and the decline of our physical and mental capacities comes with a certain sense of inevitability. Although we can argue age, like life in total, is absolutely what you make of it, indeed the ageing process in part seems to rely upon the expectation of things slowing down, becoming more difficult, while the individual has at least amassed greater experience that settles down into the aggregate layers of wisdom (as opposed to the autodidact accumulation of knowledge which so easily makes one a bore). However, for every argument that a brighter happier perspective, or a youthful resilience towards life will make you remain healthier for longer, there are also the numerous centenarians who advise us to sleep with many partners, and enjoy a stout every evening. The point is, life can easily be interrupted, and our control over this or management of death-like symptoms is essentially what healthcare deals with – but in principle life, as death, has no specific limits other than what we might ascribe to it, which is most often a number.

Save_Our_NHS_Branding_2012_Optimised.jpgSpeaking of numbers, we should consider the cost implications of life versus death – the big argument with the NHS balancing its budget in order to make it work effectively and keep NHS workers happy. Birth rates cost – until the age of 18 a child is the charge of someone – parents, foster parents or the state – after which point they are intended to be somewhat self-sufficient. Death does not cost, not really – and what really costs is keeping people alive – there is a point at which the number of health complications a person can endure overwhelms them and their body simply cannot sustain their spirit – if you’ll allow me a physical substrate here. So the ageing population is very much a good thing in terms of viva life – people are living longer and presumably a better quality of life throughout – and we have seen this trend steadily continue over the last decade.

This has altered society in many ways, ultimately increasing the number of state dependents, and older people draw state pensions, cost the NHS and social care services more as their needs become more complex and they are less independent and able to care entirely for all aspects of their own private lives. Couple this new legislation that protects taxation of the most wealthy, and sets particularly low the inheritance tax threshold, so the poorest will always lose-out more, while the richest will keep more, and the dreaded, much-lampooned “dementia tax” which sets  healthcare costs for the elderly at the door of their children, who are required to pay more towards the cost of care as their relations require greater intensity of care. This is a spiky topic, along with mental ill-health, dementia and all instances of medical senility has become the new cancer or heart disease in the public imagination – as if it had suddenly become “popular” amongst victims, and was a new viral contagion sweeping contemporary Europe (and so-called Britannia) like the original plague – this has seen droves of former Conservative supporters turn against Theresa May, and her U-turn away from her stupid, ignorant policy, until we have all come full circle – as if nothing bad had ever happened.

The sticking point is that young people are essentially in the position of propping-up the vulnerable, whether that be through direct work or taxation over the course of their own lives, and this in turn feeds the UK’s GDP/system/society – including the NHS. The current risk, is that as people have children later and later in their lives, and there is an overall decline in British birth rates, the “earning potential” of all these potential lifespans towards healthcare provision of their parents will be that bit less because they will not have worked for so long during the previous generation’s lifespan.

I’m reminded of the Clavellina experiment of Julian Huxley (brother of Aldous), whereby the Clavellina, a microscopic worm-like organism was seen to “dry out” when left without sustenance, and remove itself back into a single cell. It seems that in could stay in this near-stasis, or pre-death, forever, and then be returned to water and food and regenerate back into a version of itself, seeming to cheat death. The question remains whether each iteration is a new life, a repeat of the last one, or even a totally new organism. For me this fulfils some of the entropic character of the second law of thermodynamics, in which it is stated that entropy (increased disorder of particles) must occur if a system (such as a heat exchange) is allowed to continue indefinitely. The sticky wicket of this principle as metaphor is that it is impossible for the system to continue in growing disorder as the energy increase should, theoretically, run out.

The situation described previously, of a reduction at both ends of the age range population in the UK, fits into this model, in the sense that it is unsustainable against the harsh light of day. But perhaps there is an ethical solution, that stops just short of Logan’s Run. The title of this essay comes from an album by Foals, which was chosen after their singer read the book The Singularity of the Near by Raymond Kurzweil, which described the idea of digital selves, effectively ghosts, outliving our “human” mortal selves. Essentially humans would exist as raw data, in the most concrete spiritual sense, and go on living perhaps within a hard-drive or some such, a modern update of Walt Disney’s frozen head; having effectively transcended life itself, as many eastern mystics and Buddhists might allude to, although they continue to endure as physical bodies, perhaps out of respect for the dying and to work to alleviate suffering and cruelty.

So what’s wrong with this approach, we offer the dying an easy way out, earlier in fact, to ethically and sensibly remove themselves from existence when life has become too difficult/painful/unhappy to endure. This is not to advocate wholesale suicide, but it seems that the continuation of a digital self, might offer a legal get-out for right-to-die advocates suffering for a poor quality of life that is forced upon them, often in great pain, disability and ultimately anguish and expense for those around them. Would the most ethical solution be to allow death; with the proviso that soul or spirit would endure?

RICHARD_NIXON'S_HEAD_IN_A_JAR.pngAn interesting issue is the idea of data protection and access, could we upload Barack Obama for history lessons, much like the heads in vats of Futurama  – would it be a simulation of what he might say if he is not engaged in immediate “living” and conscious thought?

People have always posited something false or artificial in the application of the brain-in-vats experiment. As if most of our lived experience does not already end in the brain, the vessel of emotion and our human data, if you will. The argument might be that souls would simply “sit” on a data file somewhere gathering digital dust, and not be living, and all those experiences would have to be generated, maintained, and they would ultimately be false. But they would still be living; perhaps not in a sense that is worthwhile to everyone. There is also the strange phenomenon of bit-rot – whereby data files break down over time and in a very real sense, the record of information, a series of ones and zeros, breaks down, like human memory, and comes to have holes, like a brain with damaged synapses, the lack of connections cause glitches and consistently clear thought or computation becomes impossible. but it might offer the most dignified and elegant solution to reducing long-term healthcare and social work costs in supporting elderly people, especially those who are very sick and forced to “hang on”. Perhaps death is the cure to save the NHS, but it might not yet be the answer.

The essay referred to at the beginning which birthed this current article, ‘A Splintered Heart,’ is available alongside some great perspectives from all walks of life on making a tactical vote in the upcoming General Election – check it out here:



Adam Steiner
has worked as an NHS cleaner and mental heath development worker. His first novel, Politics of the Asylum, about his experiences working in the NHS is published by Urbane Publications (2017). He tweets @BurndtOutWard. Steiner’s poetry, fiction and artwork appear in The Bohemyth, I Am Not A Silent Poet, Rockland Lit, Proletarian Poetry, The Next Review, Fractured Nuance zine, BoscRev: 4, The Weary Blues. Work forthcoming: The Arsonista, Glove zine and Low Light Mag, .

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