We can’t control how we’ll die. The limits of individual responsibility

It’s important to live healthily, but scientists also tell us that the majority of cancers are down to chance – a good reminder of the limits of individual responsibility

• 
• • Owen Jones
  • theguardian.com, Friday 2 January 2015 11.25 GMT

'Most cancers are a random lightning bolt, not something we can avoid by keeping away from tobacco or excessive booze or by going for regular morning runs.' Photograph: Alamy

Our terror of death (happy new year, by the way) surely has much to do with a fear that it is out of our control. The lifetime risk of dying in a road accident is disturbingly high – one in 240 – and yet the freakishly small chance of dying in a plane accident generally provokes far more fear. We dread a final few moments in which we are powerless to do anything except wait for oblivion. So perhaps the news that most cancers are the product of bad luck – rather than, say, our diet or lifestyles – is scant reassurance. Most cancers are a random lightning bolt, not something we can avoid by keeping away from tobacco or excessive booze, or by going for regular morning runs. That’s something we have to live with.

But perhaps the news should be of comfort. It is, of course, crucial to promote healthy lifestyles. Regular exercise, a good diet and the avoidance of excess does save lives. Yet the cult of individualism fuels the idea that we are invariably personally responsible for the situation we are in: whether that be poverty, unemployment or ill health. Cancer is more individualised than most diseases: all that talk of “losing” or “winning” battles. A far wiser approach was summed up by DJ Danny Baker after his own diagnosis. He said he was “just the battlefield, science is doing the fighting and of course the wonderful docs and nurses of the brilliant NHS”. The cancer patient, in other words, was practically a bystander in a collective effort.

One of the heroes of 2014 was Stephen Sutton because of his infectious optimism and cheerfulness in the face of cancer. But his battle was about not letting cancer consume his final few months on earth, rather than a superhuman quest to miraculously defeat the disease himself. What struck me about Stephen was that a situation that seemed nightmarish to most of us became an opportunity for him to take control of his life. It is what struck me, too, about Gordon Aikman, a 29-year-old Scot with a terminal diagnosis of motor neurone disease. There is no right way to die, but he has learned how to live.

So that’s why I have some sympathy with Richard Smith, a doctor who once edited the British Medical Journal. He has upset many by suggesting we are “wasting billions trying to cure cancer”, when it is the “best” way to go. I certainly would not advocate cutting back on cancer research, quite the opposite – even if other fatal diseases don’t receive the same amount of attention – and cancer can be a horrible way to die. But his point was that it provided an opportunity to make peace, to reflect on life, to do all the things you always wanted to do – to finally have control over your own life. Other ways of dying simply do not provide that option, either because they are so sudden or because of the form they take.

We have less of a say over how and when we die than we thought. That may be a cause for anxiety: it may actually frighten us more. I think it’s liberating. If only we learned to live like many of those – like Stephen or Gordon – facing death, taking control of their lives, we would be so much happier than we are.

Loneliness is an inevitable result of Britain's economic model

The health secretary wants adults to look after their elderly parents to combat loneliness, as Asian people do. But Jeremy Hunt is wrong on who loneliness affects, wrong on what causes it, and wrong on what's happening in Asia

• 
• • Aditya Chakrabortty
  • The Guardian, Monday 21 October 2013 20.20 BST

Living alone: Britain has seen a big rise in solo living, from 17% of all households in 1971 to 31% now. Photograph: Zave Smith/Corbis

The officials who broke down Joyce Carol Vincent's door were meant to be serving an eviction notice. Instead they found her corpse slumped on the sofa, with the light from the TV still flickering over her. By 2006, she had lain there for almost three years. Rent demands and other letters flooded the hallway; the food in the fridge had long since expired and piled around her skeleton were the presents she had just wrapped, for Christmas 2003. How Joyce died remains a mystery: there was no evidence of violence and she wasn't into drink or drugs. But the bigger question – the one that catches in your throat – is how it took three years for anyone to discover her death.

An outgoing and pretty 38-year-old, she had sisters, mates, former colleagues and ex-boyfriends. Those social circles appear to have failed her. The bedsit was part of a housing estate above the huge shopping centre in Wood Green, north London, with thousands milling about. But no neighbours reported anything amiss. Joyce's body had rotted so far it could only be identified by comparing dental records with a holiday photo of her smiling. But the stench was put down to whiffy bins, and the flies and insects swarming on the windowsills were ignored.

Even such grotesque details would ordinarily have become mere local gossip – were it not for Carol Morley, who was so disturbed by the story that she made a film about her, with a tenacity of care Joyce didn't enjoy while she was alive. Morley's 2011 drama-documentary, Dreams of a Life, shows city living as a series of weak links, forgettable friendships and single people getting by in their single housing units. By the end of it, you not only understand how a person can disappear from view; you wonder how many others suffer the same fate.

Joyce's story exemplifies the social isolation decried last Friday by Jeremy Hunt as a "national shame". It's an apt subject for a health secretary to address. Studies show that chronic loneliness wrecks one's health: pushing up stress levels, increasing blood pressure, disrupting sleep, even bringing on dementia. And, yes, it kills. The Chicago neuroscientist John Cacioppo, who has researched social seclusion for decades, has tallied up the harm posed by common health hazards. Air pollution increases your chances of dying early by 5%; obesity by 20%. Excessive loneliness pushes up your odds of an early death by 45%.

Hunt doesn't dispute those findings. Indeed, last week he brought forth some shockers of his own. Such stats should make tackling isolation a public-health priority for any government. This one, however, seems to be doing its best to increase loneliness: its bedroom tax and housing-benefit cuts are wrenching families out of their communities and driving them into other neighbourhoods, even other cities.

No surprise that this didn't elicit even a sentence from Hunt. More troubling is to see a set-piece ministerial intervention – with lobby briefings, press releases, newspaper splashes, the lot – tackle an important subject in an utterly trivial fashion.

Loneliness, if we are to believe the health secretary, is a problem that afflicts only the elderly. And it can be solved by adult children looking after their parents, with "the reverence and respect" of their Asian counterparts (who also, handily enough, make do without all that welfare-state padding). In the east, you see, "residential care is a last rather than a first option"; while westerners presumably pack their folks off to homes as joyfully as if they were checking them into spas.

Well, we shouldn't believe Jeremy Hunt, because he is wrong on all counts. Wrong on who loneliness affects, wrong on what causes it, and wrong even on what's happening in Asia.

First, surveys by the Mental Health Foundation suggest that young people are more likely to feel lonely than older people. That fits with the other evidence. Britain has seen a big rise in people living alone, from 17% of all households in 1971 to 31% now. But while the proportion of retirees living alone has hardly changed over the past four decades, it's Britons of working age who are increasingly on their own. This lifestyle isn't always a chosen one: think of how the divorce rate has nearly doubled since the 60s.

Solo living coupled with a culture that exalts individualism breeds isolation. Britain's economic model grants its winners all manner of economic freedoms, but it does so while weakening social bonds. Getting on your bike and looking for work, or moving abroad to get a job, means leaving your family and friends behind. Some of these gaps can be filled by consumer onanism and by psychic palliatives such as Facebook and Twitter. But not wholly, and not for long.

In his book, Loneliness, Cacioppo puts it thus: "A rising tide can lift a variety of boats, but in a culture of social isolates, atomised by social and economic upheaval and separated by vast inequalities, it can also cause millions to drown." He might have been thinking of Joyce Vincent.

The flipside of economic individualism is loneliness. And as that model has been exported around the world, even traditionally family-centred cultures have started to crumble. This summer, Beijing passed a law compelling adults to visit their parents, or face jail. And next time Hunt sounds off about eastern reverence for the elderly, he might remember this: the best adult care home in Beijing has a waiting list that is 100 years long.

The myth of self-created millionaires

The parasitical ultra-rich often deny the role of others in the acquisition of their wealth – and even seek to punish them for it

• 
• • George Monbiot
  • The Guardian, Monday 24 September 2012 20.30 BST

Illustration by Daniel Pudles

We could call it Romnesia: the ability of the very rich to forget the context in which they made their money. To forget their education, inheritance, family networks, contacts and introductions. To forget the workers whose labour enriched them. To forget the infrastructure and security, the educated workforce, the contracts, subsidies and bailouts the government provided.

Every political system requires a justifying myth. The Soviet Union had Alexey Stakhanov, the miner reputed to have extracted 100 tonnes of coal in six hours. The US had Richard Hunter, the hero of Horatio Alger's rags-to-riches tales.

Both stories contained a germ of truth. Stakhanov worked hard for a cause in which he believed, but his remarkable output was probably faked. When Alger wrote his novels, some poor people had become very rich in the US. But the further from its ideals (productivity in the Soviet Union's case, opportunity in the US) a system strays, the more fervently its justifying myths are propounded.

As the developed nations succumb to extreme inequality and social immobility, the myth of the self-made man becomes ever more potent. It is used to justify its polar opposite: an unassailable rent-seeking class, deploying its inherited money to finance the seizure of other people's wealth.

The crudest exponent of Romnesia is the Australian mining magnate Gina Rinehart. "There is no monopoly on becoming a millionaire," she insists. "If you're jealous of those with more money, don't just sit there and complain; do something to make more money yourselves – spend less time drinking or smoking and socialising and more time working … Remember our roots, and create your own success."

Remembering her roots is what Rinehart fails to do. She forgot to add that if you want to become a millionaire – in her case a billionaire – it helps to inherit an iron ore mine and a fortune from your father and to ride a spectacular commodities boom. Had she spent her life lying in bed and throwing darts at the wall, she would still be stupendously rich.

Rich lists are stuffed with people who either inherited their money or who made it through rent-seeking activities: by means other than innovation and productive effort. They're a catalogue of speculators, property barons, dukes, IT monopolists, loan sharks, bank chiefs, oil sheikhs, mining magnates, oligarchs and chief executives paid out of all proportion to any value they generate. Looters, in short. The richest mining barons are those to whom governments sold natural resources for a song. Russian, Mexican and British oligarchs acquired underpriced public assets through privatisation, and now run a toll-booth economy. Bankers use incomprehensible instruments to fleece their clients and the taxpayer. But as rentiers capture the economy, the opposite story must be told.

Scarcely a Republican speech fails to reprise the Richard Hunter narrative, and almost all these rags-to-riches tales turn out to be bunkum. "Everything that Ann and I have," Mitt Romney claims, "we earned the old-fashioned way". Old fashioned like Blackbeard, perhaps. Two searing exposures in Rolling Stone magazine document the leveraged buyouts which destroyed viable companies, value and jobs, and the costly federal bailoutwhich saved Romney's political skin.

Romney personifies economic parasitism. The financial sector has become a job-destroying, home-breaking, life-crushing machine, which impoverishes others to enrich itself. The tighter its grip on politics, the more its representatives must tell the opposite story: of life-affirming enterprise, innovation and investment, of brave entrepreneurs making their fortunes out of nothing but grit and wit.

There is an obvious flip side to this story. "Anyone can make it – I did without help", translates as "I refuse to pay taxes to help other people, as they can help themselves": whether or not they inherited an iron ore mine from daddy. In the article in which she urged the poor to emulate her, Rinehart also proposed that the minimum wage should be reduced. Who needs fair pay if anyone can become a millionaire?

In 2010, the richest 1% in the US captured an astonishing 93% of that year's gain in incomes. In the same year, corporate chief executives made, on average, 243 times as much as the median worker (in 1965 the ratio was 10 times lower). Between 1970 and 2010, the Gini coefficient, which measures inequality, rose in the US from 0.35 to 0.44: an astounding leap.

As for social mobility, of the rich countries listed by the OECD, the three in which men's earnings are most likely to resemble their father's are, in this order, the UK, Italy and the US. If you are born poor or born rich in these nations, you are likely to stay that way. It is no coincidence that these three countries all promote themselves as lands of unparalleled opportunity.

Equal opportunity, self-creation, heroic individualism: these are the myths that predatory capitalism requires for its political survival. Romnesia permits the ultra-rich both to deny the role of other people in the creation of their own wealth and to deny help to those less fortunate than themselves. A century ago, entrepreneurs sought to pass themselves off as parasites: they adopted the style and manner of the titled, rentier class. Today the parasites claim to be entrepreneurs.