What is the post-capitalist economy of care?
Posted on December 14, 2017This past week, I attended the End Well Symposium in San Francisco, California along with New School faculty members, John Bruce and Patty Bierne, my professors for the studio course Design for Living and Dying.
End Well was a first-of-its-kind gathering that brought together an interdisciplinary community of artists, policymakers, designers, and healthcare practitioners for an inspirational day of presentations showcasing innovation in the field of care at the end of life. The day was charged with an urgency to build a movement for social change in this field.
The presentations made me reflect on the importance of “zooming out and in,” a critical design-thinking skill that is uttered constantly in the TransD program, particularly as we discuss and design in the space of wicked problems.
I was grateful for the ways in which the conference attempted to frame the space from these viewpoints. Various speakers touched upon the pain points at end of life from the micro/patient level: the unfortunate reality that so many people die in a hospital alone, despite their wish to die at home, and the macro/system pain points of western medicine’s financial incentive to treat/rescue patients, even when their health is incurable.
However, I observed two big gaps in the discussion of the day considering the scale of thinking presented during the symposium.
At the individual level: there was much discussion about the spatial/environmental of hospitals to support better care, however there was little exploration/ embodiment of the experience of time/temporality at the end of life.
Whether a person is at the end of life or they are caring for someone else who is, we know that time can take on different qualities. It can be dilated and suspended beyond the rhythm of day-to-day life as we understand it in the west. Death (excluding euthanasia) is governed by the mysterious clock of the body, versus an intellectual view of what is efficient. How the heck do we design care-experiences around that?
At the macro level: The symposium lacked a broader conversation about our broader capitalist economy and the predicted demand/supply imbalance of care at the end of life.
If we left this current system unchanged, what is the predictable future?
Thanks to advances in science-medicine, people are living longer lives. With longer-lives, come more complications in the extended years of life. This means there will be a greater/longer demand for caregiving during an elderly person’s life.
Considering the Inventing the Future reading and holding this projected future in mind, I think designers have their work cut out for them in this space. How does the future of automated technology impact this future world with such a substantially larger population of seniors?
One could propose that this is not a big problem because we can just have robots take care of the elderly for us. However, I’d like to think no one would ever desire to outsource the care of their loved ones to a robot. So, what is the alternative that meets this crisis of scale?
In America, most caregivers/family are uncompensated and are consequently under deep financial which contributes to even greater emotional stress. How can we avoid this in a world where more and more people will be faced with the pressures of caregiving in their lives?
Borrowing from the analysis from Inventing the Future, we must ask what does this scenario look like in a world with automated technology and universal basic income? The future of caregiving critically changes with both of these factors. Let us begin to imagine these implications at the system scale and that of the individual.
Srnicek and Williams provide an interesting analysis of our existing, protestant work ethic, the undergirding psychological foundation for capitalism, and its psychological foundation in a theology that puts great emphasis on reward for suffering.
This work ethic has been a useful tool for capitalism to thrive, wherein productivity is worshipped. However, this work ethic and our current economy is highly problematic for a sustainable and holistic culture for end of life-care/caregiving:
- It devalues the nonfunctional human
- It produces the myth of independence.
Our western cultural fear of dying is so contingent on the protestant work ethic. If we replaced the “reward for suffering” which produces the obsession with efficiency, I predict that we would naturally stop fearing death so much, because we would learn how to die throughout our lives.
By that I mean, if our culture was designed in such a way that respected leisure time, (perhaps more appropriately rebranded as “well-being time),” it seems to me that it would better prepare us for the reduced function or non-functional state we will inevitably experience at the end of life. It would reduce the competitive nature we have with ourselves. This post-capitalist proposal does not argue for humans to be given permission to be lazy, but it is an argument for a work-ethic that does not predicate self-worth on productivity ,and/or, that productivity is expanded to refer to much more creative, communally-focused ideas of time-management. Certainly one that values caregiving as a meaningful use of time. Not one in conflict with time-sucking career-ladder climbing.
What are the next steps for designers?
- I think we really need to bring greater imagination to the field of end of life, particularly with speculative design projects that can model the end of work and how society/policy can elevate the identity and dignity of caregivers supporting people at the end of life. What is the work-ethic of this society? What choices will people make with regard to the ways that they age in a world that will sell them on a “cure for aging”?
- Design can’t be a victim of the consumerism that fuels it. I believe that consumerism, in its effort to prolong the period of the individual’s active consumption indirectly and directly enables a fear and avoidance of death— a time without consumption. An obvious example of this is the extraordinary amount of money that is spent to help people slow/reverse/hide aging. A fetish for youthfulness, all of these advertising promises are a strategy to make us find aging and dying ugly and unnatural. Not ALIVE.
- The truth is that the opposite of death isn’t life- it’s birth. Death is part of life, it affirms life. I believe designers can help reshape our culture by “embracing death” as an affirmation of life instead of avoiding it. Designers can’t be afraid to think, talk, and make work that deals with aging and death.
- In a post-capitalist future, I doubt that we can outgrow capitalism and replace the protestant work ethic without some kind of organized religion. Perhaps there will be a merger/cooptation/emergence between religions and design from which a new mass-ideology regarding wellbeing and work can support a more sustainable economy. I often feel design lacks the vigor and endurance that religion in its thousands of years of history possess. Can we animate a passionate, universalist work-ethic without over-secularizing it to the point of boredom and meaninglessness?
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The most resonant message and feeling from this conference and from my studio research this semester is that a good death truly implies a good life, and that this topic matters because we ultimately want to dignify the human-experience throughout one’s existence.
•Nick Srnicek and Alex Williams, Inventing the Future
•painting: Philippe de Champaigne, “Vanité” (c. first half of 17th century).