The Perils of Autonomy & Independence

Interdependence: Three Sisters Garden, Tsyunhehkw^, Oneida Nation, Wisconsin

It’s often said that the Baby Boomers – 10,000 of whom are turning 65 each day now – are going to transform how we age and how we die. But I’m troubled by the form this seems to be taking.

Everywhere I see mottos of individual entitlement: “My Life. My Death. My Way.”

Every day my in-box contains another manifestation of this. A recent invitation offers a digital tool to join in “living well, dying better, and being remembered the right way….Achieving immortality has never been easier,” we’re assured “…in as little as an hour.”

Last week, thousands of people gathered in community meeting halls around the country to watch Dr Atul Gawande, bestselling author of Being Mortal, in a simulcast talk on “The Value of Community and Choice As We Grow Older”. Setting the stage for his description of the problem, he referenced the three plagues of growing old: boredom, loneliness, and helplessness.

Most of the event was then devoted to solutions enthroning autonomy, independence, and control as our unquestioned, highest goals. Goals for how we age and how we die. More than goals, demands. Demands that bear a remarkable resemblance to the demands of a teenager flying the coop: autonomy, independence, control.

No one asked the question: Might our insistency on autonomy have something to do with ending up irrelevant and bored? Might our devotion to independence bear any connection to our epidemic of loneliness? Might our addiction to control be connected to the despair of helplessness?

Being a burden on family consistently ranks in the top three fears of older people. And in our autonomous, independent, control-addicted society, caregivers are often disastrously burdened, attempting to do solo what was once carried by a village.

Andrea Carlisle’s moving essay When We Were Two, about caring for her nearly-hundred-year-old mother, cites the gender-specific nature of that burden even as it beautifully articulates the cost of no longer being tethered to that role.

I’ve left being a caregiver behind, but there are still days when I need to push myself to carve purpose from the stubborn stone of a so-called “carefree” life. ~ Andrea Carlisle

I spent many a day changing my father’s diapers before he died of brain cancer, just shy of 65 years old. Hours on the floor with him, unable to lift him back in bed after he’d fallen. Cutting his toenails, shaving his steroid-swollen face. I’ve been on call for, in examining rooms with, and at the deathbeds of, friend after friend.

I’d be the last personal to glamorize caregiving. But I’m no longer willing to venerate autonomy and independence.  I see control as a trickster; our insistence on it, an understandable but unreliable coping mechanism.

What I’ve seen of my mother’s involvement in community-building through the Village movement – despite its emphasis on autonomy, independence, and control – might be called, more accurately, interdependence. Living, and maybe even dying, in a way that reveals a fundamental aspect of our humanity: we need each other.

9 Comments on “The Perils of Autonomy & Independence

  1. I have attended the needful to dignify my loved ones in their end without apology. Their trust in me led to their learning to float as they left the transactional cares of this life. In all I have learned or experienced, attending the dying has been the most rewarding. That, and attending the birth of souls coming into this world!

    • Thank you, Brenda, for sharing something of the care you’ve provided to others.

    • Thank you, Marilyn, for adding your deeply informed perspective, as a minister, on the larger framework in which these questions can be considered.

  2. Dear Holly, I don’t think autonomy and independence necessarily lead to isolation and loneliness. I hear (and read) Gawande urging respectful listening to understand how we define a good life and death for ourselves and helping us to achieve that as far as possible. He contrasts this with the regimentation of nursing homes, where everybody eats the same thing at the same time. Our village, now 7 years old, encourages interdependence and community. I do agree with you about our fetish with control. We really cannot control what happens to us, by way of aging, ailing, accidents, or death, much less what happens on our behalf after we die. xoxomom

    • What could be better than having one’s own mother comment, so thoughtfully, on one’s blog?!

      I hear and read Gawande as you do, and appreciate that he has popularized the reframing of the medicalized question of “fight or give up?” to “what are you fighting for?” (even as I wonder whether “fighting” is the appropriate verb). I also appreciate that he has said “needing more help is not a failure” – much as we should understand that death is not a failure.

      And I agree with you that autonomy and independence don’t *necessarily* lead to isolation and loneliness, on an individual level (though I can think of many examples where they do).

      But, speaking on the level of culture – and Gawande helpfully frames these as cultural problems – I’m troubled that these contemporary movements lead the charge with “autonomy and independence” rather than the values you’ve named: “interdependence and community”. We live amidst not just a fetishization of control, but a fetishization of the individual. The call for “autonomy and independence” sounds a lot like “every man for himself” even when I know there’s more to what’s being sought.

      My plea is for an approach that doesn’t deepen the same cultural ruts that, I believe, are partly responsible for the very problems these solutions are trying to address.

  3. Hi Holly–here is my take, despite not having listened to the webcast in question. I agree–independence and autonomy are in my opinion the bain of today’s society and frankly I feel like they are offshoots of the American dream and “pulling oneself up by one’s bootstraps”. It is capitalism and when you think about it, death is an industry in service to capitalism and fear of dying and grieving are in themselves the root of so much grief in western culture…so when someone talks about independence and autonomy for the aged, it should never be at the expense of community, which of course involves dependence on others. It irritates me to no end when I see “independence and autonomy” referred to in the context of life goals. To isolate them as such is to isolate the person. Being independent and autonomous in conjunction with living in community is an entirely different thing.

    • Thank you, Edie. I value your perspective as a Canadian (and first generation, of European-born parents) observer of American culture; as a mother of young kids; and as one whose own mother died young.

      Atul Gawande isn’t calling for autonomy and independence in isolation; he points to the importance of community, consistently, and says “needing help isn’t a failure. But I think the elevation of “autonomy and independence” as the primary battle cry is more symptom of than solution for the times we’re in.

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