ZetaTalk: Social Services
Note: written Dec 15, 1995.

After the cataclysms the snug blanket of protection that many have taken for granted will be gone - no Social Security checks, no home deliveries, no 911 emergency service, no free medical services, and no welfare checks. For those not relying on those services the shock will be as great, as with home, job, and service providers gone they will be just as destitute and bereft. In essence, humans will be relying on one another, and not on an infrastructure. What will this mean? In most societies there are rules about who should live and who should die, even when these rules are not articulated. Many American Indians let their old choose the time of their departure, a spiritual and poignant moment for all, as the old were a burden on the young that all agreed could not be borne. In some cultures malformed infants are not nourished, and all cultures push what they consider their undesirables to the periphery, to wither and perchance to die.

After the cataclysms new rules will spring up, depending on the desperation of the community and whether a Service-to-Self or Service-to-Other orientation prevails. In Service-to-Self groups the strong will prey upon or ignore the weak until a homeostasis is established. What this means is that injured or frail humans will be ignored, not fed or assisted, and they will die. If they refuse to go quietly they will be killed, and if food is short they will be killed and eaten in any case. Eventually the group reaches a point where there are no young, old, or injured and the pecking order among the remainder is well established. In Service-to-Other groups, those hopelessly maimed or chronically in pain will be allowed to choose suicide, and birth control will be used to limit the demands on scarce resources, if need be. All who wish to live will be fed and cared for, sharing equally among all. In crisis mode, when overwhelmed by large numbers of injured members in great pain, Service-to-Other groups usually end up prioritizing care in the following manner:

• Where the injury is clearly life threatening and the outcome inevitable, making the injured comfortable is the only treatment given. This should be explained firmly and kindly to the injured, as a choice between treating those who could benefit or wasting effort on one who could not benefit. If the injured is in pain, this means pain medication to the point of stupor or, if no medication exists and the pain is extreme, assisted suicide. Contrary to what humans may have been led to believe, individuals in severe, chronic, and hopelessly painful situations invariably request to be allowed to die. They beg for this, in fact.

• Where the injured still outnumber the capacity of the caregivers, quality of life next enters the equation. Will a life be saved only to live in pain or in a diminished capacity, or will a life be saved and restored to full faculties? In this determination full faculties does not mean the blind or amputee should be neglected. Full faculties means reasonable mental faculties, the ability to eat and eliminate without humiliation, the ability to live without being perpetually hooked up to machines, in short, a life one could tolerate rather than a life one would dread. Here again the decision should be explained to the injured, who may exhort the caregivers to reconsider if they don't agree with the decision. Be firm, as vacillation only tortures the injured who should be allowed to come to terms with the situation. Remind the injured of the others who also cry for help.

• If the injured still overwhelm the caregiver's capacities, choices fall along lines familiar to humans. Treatment quickly given, such as a tourniquet to prevent the injured from bleeding to death, is chosen over treatments that would take more time, such as surgery to stop internal bleeding. Lavage of poisons eating at skin takes precedence over removing a splinter piercing an eye or a limb. Preventing shock takes precedence over setting a broken bone. The caregivers should be firm and committed during such a process, and not expend precious time arguing with those in pain and frantic with anxiety over their injuries.

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