Written by on September 29, 2014 in Blog with 1 Comment

final exodus blog A leading bioethicist chooses not to live past age 75.  Yet he refuses self-deliverance after 75. Both choices seem strange to me.   What is your reaction?

Ezekiel Emanuel* says that while his death would be a “loss,” it would also be a “gain.” In his view, living too long “renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived.  It robs us of our creativity and ability to contribute to work, society, the world.  It transforms how people experience us, relate to us, and, most important, remember us.  We are no longer remembered as vibrant and engaged but as feeble, ineffectual, and even pathetic.”

After giving these words some thought, I am inclined to agree with Emanuel.  But not with his timing.  I’m in my late 70s.  I know people, inside and outside my family, who are in their late 80s and still are vibrant, strong and contributing to society.   In my view he is dead-wrong to assume 75 is the magic line between a contributing life and a “deprived” state.   Unless we suddenly die, we all cross that invisible divide before we die, but it will be at a different age for each of us.

Emanuel’s view is utopian and un-selfish in many ways.   Most of us, including me, will take a different, less egalitarian, view.  Mine will be the quality of my life.  When I can’t do certain things I’ve crossed my line, and will choose self-deliverance.

But Emanuel refuses self-deliverance.   Instead, he will, at 75, simply refuse all medical treatment that would extend his life.  He will accept palliative but not curative care.

He misses a critical fact:  Many disabilities in old age are not life-threatening.   For example, some infections can and will lead to death, but a urinary infection won’t, but if not treated it can make life miserable.  Another example: some disabilities will make you bed-redden but won’t kill you.  Do you want to spend the rest of your life in bed?  Not I.

Emanuel takes aim at a cultural type which he calls “American immortal.”  “Americans seem to be obsessed with exercising, doing mental puzzles, consuming various juice and protein concoctions, sticking to strict diets, and popping vitamins and supplements, all in a valiant effort to cheat death and prolong life as long as possible.”  Indeed I’m guilty of some of these, so I am a member of this American Immortal class, except…. Except that I disagree with “as long as possible.”  I won’t continue my effort to extend my life when my quality of life is no longer acceptable to me.  When that time comes, I will not only stop my effort, I will exit life.

Emanuel rejects this immortal aspiration.  First, he says society is spending too much money extending life, and not enough to save young people (and presumably to educate them).

Second, “compression of morbidity” is not working.  While we are definitely living longer, the longer life is not allowing us to live better.  Rather we are in a continual state of decline.  “So American Immortals may live longer than their parents, but they are likely to be more incapacitated.  Does that sound very desirable?  Not to me” Emanuel says.

This attitude he says places real emotional and financial weights on our progeny, which we need to recognize.  I agree wholeheartedly.  Let’s not place undue emotional, physical and financial burdens on our children.  But I’ve not done so, at 75, nor at 78, and I hope for many good years to come.  Again, the question is not whether I agree or not; rather it is, when does this time come?

Emanuel says we need to ask ourselves “whether our consumption is worth our contribution.”   Indeed we need to ask ourselves.  Behind that simple question are the complex questions of the meanings of consumption and contribution.  This is quicksand that I don’t wish to get stuck in, at least today.



*Ezekiel Emanuel is director of the Clinical Bioethics Dept. at the National Institutes of Health and is a professor at the University of Pennsylvania. If the name “Emanuel” sounds familiar to you, his brother, Rahm, is the mayor of Chicago and was President Obama’s first-term chief of staff.  His article from which I quote, Why I Hope to Die at 75, appeared in The Atlantic magazine September 17, 2014.




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  1. C.T. says:

    ‘Unendurable’ PAIN will lead me to a EUPHORIC SE self-euthanasia almost anytime.. As Christian I see it as BEGINNING my promised eternal life… Where all is JUST & BEAUTIFUL… What has been awaiting me forever… Peace & Blessings

    I’ve always find this fine website’s creator Bill’s Topic writings outstanding, and also see the arbitrary age of 75 to die at odd.

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