Cause and effect is actually a philosophical concept, though so widely talked about you’d think it was scientific fact. The idea that two events can be related to each other actually starts at around 8 months of age, when infants begin to shake rattles, splash water, or drop objects from highchairs. These simple direct relationships evolve to more abstract concepts as children begin to learn that behaviors can have both positive and negative consequences.
Essentially, we are hard wired to look for causality. Knowing that A + B = C gives life order, and offers us a sense of control. The more chaos and anxiety in our lives, the more we will seek out cause and effect relationships. If we can attribute the negative things to something or someone, the unexplainable becomes explainable, and in doing so the illusion of control grows, ultimately reducing our anxiety.
You can probably guess at what point in life we are guaranteed to readily seek out cause and effect; near the end. It doesn’t matter what disease or condition we may be facing, death is out of anyone’s control, therefore in an effort to reduce the anxiety surrounding the unknown, we look for answers.
I hear it said in many different ways, but everyone is basically asking the same question; Why? What caused this? And behind that question, sometimes, is the question of culpability. Did I do something to get here? Did someone else not do something, which led me to here? Who is to blame for the fact that I’d dying?
Unfortunately, because of the way our medical system is set up, many diseases already have a scapegoat identified. Lung cancer: smoking. Heart disease: diet and exercise. Liver failure: alcohol. This very wrong over simplification is what healthy people do to convince themselves that they can avoid sickness by being in control of their choices.
The truths about cause and effect in regards to illness and disease are these: We are not 100% in control. We know that genetics, the environment, nutrition, behavior, and random chance all play equal roles in our health. We are the sum of choices made throughout our entire lives. The cigarette smoked this morning is no more responsible for lung cancer than the face full of campfire smoke inhaled at the age of 8. In other words, to try and decipher out one decision, or one behavior, or one mistake as the ultimate reason to why death is near, would simply be impossible.
As humans, I don’t expect that we will ever stop asking why, but perhaps we should pay more attention to the answers we’re trying to find. No one at the end of life should have to experience self-blame or societal blame. While blame may help displace some of the anxiety and anger surrounding death, blame is never helpful in the long term.
As friends and family members of those with serious illnesses, the best thing we can offer when confronted with questions about cause and effect is a non-judging ear to explore, an awareness of probable anxiety, and redirection to the things that are in their control.