"Honor thy father and thy mother..." (Exodus 20: 12)

Writing in The Weekly Standard , Yuval Levin observes that in the last few election cycles, significantly greater attention has been placed on foreign policy than domestic policy. "Apart from immigration and the vague odor of corruption," he says, "it is hard to find a single domestic issue that candidates consistently stressed on the stump this year." This, however, will not always remain the case, and Levin believes that conservatives would do well to develop a fresh perspective on domestic policy. This policy, he argues, should be geared toward the concerns of the "parenting class". Levin discusses the anxiety many mothers and fathers face in the current economy. He says that one of the primary concerns confronting more Americans every year is how to meet the needs of their aging parents.

It's a big problem, and it is only going to get worse in the next few years. America is undergoing a remarkable demographic shift that will change the face of our nation. In 2005 there were 36 million Americans over age 65. Within thirty years, this number is expected to double. Because people are generally having fewer children, however, there will be fewer young people to take care of their aging parents. There will be more elderly men and women requiring long-term care and fewer young people to provide it.

When commentators discuss the fact that America is getting "grayer", they often talk about the problem in economic terms, which is perfectly understandable. After all, the elderly often require expensive care, yet they rarely produce money in their old age. Who will foot the bill? It is often noted that the economic crisis associated with the "age wave" will also be a crisis for the government. Medicare is slated to run out of money in 2018. A year before that, in 2017, Social Security will begin paying out more money than it receives in taxes. As the baby-boomers begin to retire these government programs will be stretched to their limit, and eventually the programs will not be able to meet the demand.

As ominous as the economic crisis is, there is an even greater cultural crisis. Many talk about the elderly as if they are merely parasites draining our time and money. Older men and women are often treated with little respect. I see it every day in my law practice, where I frequently represent men and women who are victims of nursing home abuse and neglect. Weak and helpless grandmothers and grandfathers are at the mercy of their caregivers who all too often are short of the staff and supplies necessary to provide adequate care because their employers are busy pursuing profits over people. The result is an epidemic of preventable pressure sores, malnutrition, dehydration, and falls among the institutionalized elderly.

Other than the unborn, no single age group in the United States suffers from a diminished view of the value of human life more than the elderly. We have adopted a sliding scale of dignity which depends upon one's functional capacity, quality of life, and level of sentience. Woe be unto the old person who does not score well using this quality of life calculus and who costs more to maintain than they produce.

There is no doubt that the Roe v. Wade ethic has had a striking effect on how we view the aged. Roe teaches us to look at other people in terms of how convenient they are to us. If someone is wanted, then their life has worth; if not, it is permissible to dispose of them. Now that we are facing a future where elderly men and women will be seen as economically inconvenient, where some will be unwanted and unloved, and where many will lack the mental or physical capacity to defend themselves, it is clear that the elderly are in danger of abuse, neglect, or perhaps even worse.

Increasingly, as a society we are demonstrating that we are willing to negotiate whose life is worth living, and whose life is not. These negotiations are done very publicly when it comes to the pre-born. The discussion is not quite as candid when dealing with the elderly—not yet, at least. Still, we are seeing more and more signs that people are ready to enter the negotiation. They are beginning to pose the questions: Is life under certain conditions really worth living? What are the circumstances that result in the forfeiture of one's right to life? Will a lack of self-awareness do it? Will the necessity of a feeding tube be enough? At what point do the elderly have "a duty to die and get out of the way," as posited by former Colorado Governor Richard Lamm. Notably, these questions are almost always posed by someone other than the person who is experiencing the unwanted condition. Stripped of their gloss, these questions might be rephrased, "Is it really fair that I should have to make sacrifices for this sorry life form? Isn't my comfort more important?"

This conversation is only now beginning, but as we approach the demographic changes ahead the debate will become increasingly acceptable in the public square. What was once seen as unthinkable may slowly become inevitable: "Of course the elderly should be given the dignity of a peaceful death! What kind of monster are you, desiring that they should suffer and decline over several painful years!"

The demographic and economic crises are real, but even more important is the crisis of human dignity. Will we allow ourselves to see the elderly as an inconvenience to be managed, or as people who are to be nurtured, cared for, and cherished? Will we see the dignity in their lives even when they are no longer useful to us? Will we love them regardless of their abilities?

In the increasingly utilitarian age in which we live—an age where moral absolutes are mocked and the notion of transcendent truths is ridiculed—the answer to these questions can be terrifying.