Column
Ageing
Character
Comment
Politics
5 min read

What the Joe Biden story tells us about growing older

Rather than mimicking the young, the elderly witness to a life well lived.

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

Joe Biden holds a fist to his chest as he stands and speaks.
Biden at the CNN presidential debate.

President Biden has had a few bad days at the office recently. Time and again, he seems to freeze in public, stumbles over his words, as his voice falters and his sentences tail off. At his first public debate with Donald Trump, he looked just like a man in his eighties, struggling to remember facts, his mind not as alert as it once was. Which, come to think of it, is exactly what many people in their eighties are. And Trump is no spring chicken either. Questions around age dominate the American Presidential election like never before. This is a story of not of two elderly gents in a bar arguing over their fading memories of the past, but between candidates wanting to be the most powerful man, in charge of the most forbidding military and economic powers on the planet. 

Old age creeps up on us slowly. To tell when it starts is hard to say. Yet we all know how it ends. Old age is a kind of preparation for death, a slowing down of faculties, a loss of control, a gradual diminishing of powers, preparing us for a new kind of life beyond this one. As a result, in our achievement-oriented age that doesn't believe in a life beyond death, we are tempted to ignore the elderly, shutting them away in residential homes, out of sight and out of mind.

Yet they were valued for what they were – signs of where we are all heading, their stories as object lessons for the young in how to live well (or badly). 

Old age, however, is not a slide into passivity. Even as powers diminish, elderly people still have significant agency – keeping the mind active through reading, walking to the shop to buy bread, keeping in touch with relatives, even getting out of a chair as the end draws near can take as much resolve and determination as the more complex tasks of our youth, and are every bit as heroic and human as the more impressive achievements of our sprightlier years.  

Former cultures respected the elderly for the experience gained, as members of the community to be looked up to, respected and valued. Teenagers were not considered as the moral arbiters of the future but as immature human beings who still have a lot to learn. The old were given pride of place as those who had gained the wisdom of years. Not that that wisdom was always apparent - the elderly can become cantankerous, repetitive and self-focused as powers diminish. Yet they were valued for what they were – signs of where we are all heading, their stories as object lessons for the young in how to live well (or badly).  

The one time when we do place elderly people front and centre, is when they are able to do the things that young people can. Adverts regularly depict old people jumping out of planes, playing rugby, strumming electric guitars - doing the things that young people typically do. Old people who can pretend that they are young are praised to the hilt. Elderly people who lose their memory, their train of thought, stumble and repeat themselves are looked on with pity, not respect. When they do both it confuses us – which is why everyone is worried about Joe.  

Part of the wisdom of old age is to recognise when it has come upon us, and what its distinct calling is. In a strange echo of our culture's attitude to the elderly, Joe Biden seems desperate to tell himself and others that he's perfectly capable of doing the job of President, a job that would come much more naturally to someone 20 years younger than him. Surely the wiser and more sensible course would have been to recognise the signs of time, and halfway through his presidency, to have announced that he was not standing again, triggering a leadership race among the Democratic Party so that a new candidate could be ready for the Presidential election without all the doubts about age and capacity in mind. 

So, caught between ignoring old age and yearning for lost youth, how then, are we to value the ageing process? After all, one day, it will come on all of us who manage to avoid a premature death.  

The main task as the years pass and the shadows lengthen, is to be there for the young,

If we remain active throughout our lives, that activity changes over time. As someone well into my sixties, approaching old age (or perhaps already in it – it is hard to tell?) I recognise my body creaks and does not adapt as it once did. I can't do all that I could in my 30s or 40s. Over time, callings change, and recognising that is part of the wisdom of life. The Christian ethicist Oliver O'Donovan suggests that the calling of old age is to "stand by the side of youth." Elderly people have the task "to show to the young how their generation, the only earlier generation to which the young have direct access, has conceived its tasks and tackled them. If the young are to form their world effectively, they will need models to inherit and to build on."  

The prime task of old age is not to withdraw into some retirement village, playing golf every day, going on endless holidays, living the life we wanted to live in our 40s but couldn't because we had to work. It is not to enjoy retirement as a kind of secular heaven, a reward for a lifetime of hard work, with pleasures abounding. There may be time for some of that, but the main task as the years pass and the shadows lengthen, is to be there for the young, not to tell them what to do but to be a witness of a life well lived - or sometimes an object lesson of a life lived badly – often both at the same time. It is to be a sign of how another generation managed to navigate the complications and complexities of life and how for those who have a faith, as a witness to how God has proved faithful over time, space and the shifting sands of culture. And that involves focus from both sides. The younger need to value, respect and prize the elderly for what they offer as a model of life lived and complexity negotiated, and the old need to recognise their changing role as it creeps upon them with the passing of years. 

The calling of the elderly is just as important as that of the young or even the middle-aged. Yet it is different. We need to value our older people, not because they can do the things younger people can, but because they are object lessons in how to navigate life, and how to prepare for the next one.  

Getting it muddled up helps no one. 

Article
Care
Comment
Economics
Ethics
4 min read

NHS: How far do we go to feed the sacred system?

Balancing safeguards and economic expediencies after the assisted dying vote.

Callum is a pastor, based on a barge, in London's Docklands.

A patient eye view of six surgeons looking down.
National Cancer Institute via Unsplash.

“Die cheaply, protect the NHS” It sounds extreme, but it could become an unspoken policy. With MPs voting on 29th November to advance the assisted dying bill, Britain stands at a crossroads. Framed as a compassionate choice for the terminally ill, the bill raises profound ethical, societal, and economic concerns. In a nation where the NHS holds near-sacred status, this legislation risks leading us to a grim reality: lives sacrificed to sustain an overstretched healthcare system. 

The passage of this legislation demands vigilance. To avoid human lives being sacrificed at the altar of an insatiable healthcare system, we must confront the potential dangers of assisted dying becoming an economic expedient cloaked in compassion. 

The NHS has been part of British identity since its founding, offering universal care, free at the point of use. To be clear, this is a good thing—extraordinary levels of medical care are accessible to all, regardless of income. When my wife needed medical intervention while in labour, the NHS ensured we were not left with an unpayable bill. 

Yet the NHS is more than a healthcare system; it has become a cultural icon. During the COVID-19 pandemic, it was elevated to near-religious status with weekly clapping, rainbow posters, and public declarations of loyalty. To criticise or call for reform often invites accusations of cruelty or inhumanity. A 2020 Ipsos MORI poll found that 74 per cent of Britons cited the NHS as a source of pride, more than any other institution. 

However, the NHS’s demands continue to grow: waiting lists stretch ever longer, staff are overworked and underpaid, and funding is perpetually under strain. Like any idol, it demands sacrifices to sustain its appetite. In this context, the introduction of assisted dying legislation raises troubling questions about how far society might go to feed this sacred system. 

Supporters of the Assisted Dying Bill argue that it will remain limited to exceptional cases, governed by strict safeguards. However, international evidence suggests otherwise. 

In Belgium, the number of euthanasia cases rose by 267 per cent in less than a decade, with 2,656 cases in 2019 compared to 954 in 2010. Increasingly, these cases involve patients with psychiatric disorders or non-terminal illnesses. Canada has seen similar trends since legalising medical assistance in dying (MAiD) in 2016. By 2021, over 10,000 people had opted for MAiD, with eligibility expanding to include individuals with disabilities, mental health conditions, and even financial hardships. 

The argument for safeguards is hardly reassuring, history shows they are often eroded over time. In Belgium and Canada, assisted dying has evolved from a last resort for the terminally ill to an option offered to the vulnerable and struggling. This raises an urgent question: how do we ensure Britain doesn’t follow this trajectory? 

The NHS is under immense strain. With limited resources and growing demand, the temptation to frame assisted dying as an economic solution is real. While supporters present the legislation as compassionate, the potential for financial incentives to influence its application cannot be ignored. 

Healthcare systems exist to uphold human dignity, not reduce life to an economic equation.

Consider a scenario: you are diagnosed with a complex, long-term, ultimately terminal illness. Option one involves intricate surgery, a lengthy hospital stay, and gruelling physiotherapy. The risks are high, the recovery tough, life not significantly lengthened, and the costs significant. Opting for this could be perceived as selfish—haven’t you heard how overstretched the NHS is? Don’t you care about real emergencies? Option two offers a "dignified" exit: assisted dying. It spares NHS resources and relieves your family of the burden of prolonged care. What starts as a choice may soon feel like an obligation for the vulnerable, elderly, or disabled—those who might already feel they are a financial or emotional burden. 

This economic argument is unspoken but undeniable. When a system is stretched to breaking point, compassion risks becoming a convenient cloak for expedience. 

The Assisted Dying Bill marks a critical moment for Britain. If passed into law, as now seems inevitable, it could redefine not only how we view healthcare but how we value life itself. To prevent this legislation from becoming a slippery slope, we must remain vigilant against the erosion of safeguards and the pressure of economic incentives. 

At the same time, we must reassess our relationship with the NHS. It must no longer occupy a place of unquestioning reverence. Instead, we should view it with a balance of admiration and accountability. Reforming the NHS isn’t about dismantling it but ensuring it serves its true purpose: to protect life, not demand it. 

Healthcare systems exist to uphold human dignity, not reduce life to an economic equation. If we continue to treat the NHS as sacred, the costs—moral, spiritual, and human—will become unbearable. 

This moment requires courage: the courage to confront economic realities without compromising our moral foundations. As a society, we must advocate for policies that prioritise care, defend the vulnerable, and resist the reduction of life to an equation. Sacrifices will always be necessary in a healthcare system, but they must be sacrifices of commitment to care, not lives surrendered to convenience. 

The path forward demands thoughtful reform and a collective reimagining of our values. If we value dignity and compassion, we must ensure that they remain more than rhetoric—they must be the principles that guide our every decision.