Necroneoliberalism, MAiD, and the ‘karenification’ of life and death

Thought to emerge from Black social media, a ‘karen’ is a pop-culture memetic device for a person, typically but not exclusively white, middle-class, and initially a woman, who demands absurd remedies or makes vexatious complaints about real or perceived inconveniences, however minor or biased, and sometimes actively racist. In their paper exploring the karen phenomenon and its Schroedinger nature of reflecting both privilege and vulnerability, scholars Diane Negra and Julia Leyda conclude,

“In this sense, ‘Karen’ requires recognition as a caricature of the new precarities of middle-class life. In her (increasingly doomed) efforts to exert a sense of agency in late capitalism, ‘Karen’ seems to seek an ontological reassurance that consumer capitalism is on her side (and on the side of whiteness).”

All that said, I don’t like the term, given its pejoratively gendered nature. It came to mind with MAiD, so I will introduce it cautiously here because it helps frame what might be a complicated point.

The dodgy cases of Medical Assistance in Dying (MAiD) we’ve seen reported for minor issues and the expansion to people who are not dying, underpinned by the rationale of autonomy or ‘patient choice’, sometimes comes across to me as a karenification of life and death. That is, they reduce the value of life to an assessment of how well it conforms to one’s expectations, for which death is compensation.

A karenified life is stripped of its intrinsic value. It has no tolerance for warts and bumps. It is a privileged life that demands various bespoke ‘choices’ and preferences. Personal responsibility does not exist here, as *someone else* must be responsible for any inconvenience or lack of agreeable choices. It is a botoxic life, where the entropy of ageing is an enemy to be fought, and disability is anathema. Sense of security (physical, economic…racial) must be absolute, and the world is there to serve the individual. 

With MAiD, death at the hands of the state, by an agent of the state can be demanded for physical and (soon) mental illnesses if a person claims life is now intolerable. Will physiotherapy, a minor surgery, a lifestyle change, or something else fix the problem? Yes, but if you can’t be bothered to try because you shouldn’t have to do things like that, death remains on the table. The law even says so.

“that illness, disease or disability or that state of decline causes them enduring physical or psychological suffering that is intolerable to them, and that cannot be relieved under conditions that they consider acceptable.”

Enter neoliberalism. Neoliberalism is a capitalist economic ideology that, at a macroeconomic level, champions free markets and free trade, the privatisation of goods and services and correspondingly ‘small’ government. Globally, it’s been used by multilateral organisations like the IMF and World Bank, or wealthier EU countries, to demand devastating ‘structural adjustments’, the abandonment of protectionist policies in poorer economies in exchange for development or bailout loans. This approach, unfortunately, exposed these countries to the vagaries of the global casino economy and exploitation by multinational corporations seeking cheap resources and labour. The ‘invisible hand’ of the market was supposed to lift incomes, make boats fly, or some damn thing, but in reality created terrible debt, poverty, and misery for millions of people. 

Nationally, neoliberalism informs many conservative and liberal policies, differing in degree and scope of application. Liberals see a role for the government to create a regulated enabling environment for the private sector but still provide some essential services. Liberals also see the state as facilitating and protecting individual choice or autonomy, viewed as extensions of constitutional or human rights. Conservatives since the 1970s mostly want to drown the state in the Bellagio’s water fountain and let the high-rollers try running things. It appears anytime you see drastic cuts to health and social services in the name of efficiency or fiscal responsibility. However, these days, many conservatives are leaning hard into fascism and increasingly see the state as a tool to crush social diversity and protections to ensure a few chosen playboys can run the casino.

Neoliberalism’s wicked trick is to transfer (a sense of) responsibility for social and economic welfare from the state to the private sector and then, finally, to the individual. It is often sold as a ‘choice’ at this last domain. When you hear a politician or business leader say, "We want to give consumers more choices!” you hear neoliberalism. However, the ‘choices’ they are talking about typically mean goods or services defined by them, not you, aimed at transferring money from your accounts into their own or their friends. Neoliberal organisations thrive where individuals have enough disposable income or credit. They do not thrive when that income or credit evaporates, which means they either fail or get bailed out by governments. Individuals like you and I are not typically bailed out when we lose income and credit and are left to flail and fail.

If you’re poor, elderly, or a person who is ill or disabled, no longer has disposable income or credit, or at least can’t spend the same way, and may rely on the state or others to support you, you aren’t much of a consumer. You can’t buy much in goods or services, so your choices to spend and consume are limited. You’re a liability. A burden. You have no dignity because dignity is choice, and choice is consumption, and consumption needs money. 

If your family or friends, charities, or the state supports you, they spend money and resources that could be better exchanged for cars and houses and 50-inch flat screens. You are costing the taxpayer (i.e., privileged people who are not poor) money, which they should spend on goods and services. Consumers and taxpayers here are parts of a machine, not people, not human beings. You might be forgiven for internalising this thinking if you’re bombarded with this messaging long enough. 

Enter MAiD. MAiD presents you with the choice between life and death. An agent of the neoliberal state is willing, even enthusiastic, to kill you if your ‘choices’ as a ‘consumer’ narrow beyond a certain degree, and you become a burden because being a burden, read as ill, old, poor, or oppressed, is a loss of dignity. 

For some who seek MAiD, as we’ve seen, the state does not provide sufficient support for their health conditions. Many others are already near death. Yet for others, life is just happening as it always has, and ageing, illness, or their awareness of mortality have set in in ways they didn’t expect.

This leads to the agents of neoliberalism presenting you with another ‘choice’. They sell you the idea that your changing health or circumstances, your suffering, means you’ve lost “dignity” (never mind that woke hippie nonsense about your dignity being inherent and intrinsic). 

‘Gosh, my dignity! I don’t want to be like them, those poor people with arthritis or diapers who are such burdens. I’m not like them. I paid good money for this life, and I demand service!’ 

‘But wait!’ they say. 

‘You still have choices! Our MAiD ‘treatment’ is guaranteed to stop suffering and restore dignity. You don’t even have to do it yourself! Our doctors or nurses do it with just a few quick injections. Here, read these reviews on our website! (you just have to nevermind the fine print that none are from people after they’ve had the procedure)’

And you say, 

‘Oh yes, thank you, I’ll have that! Can I book it in advance?’

“Ontological reassurance”, indeed.