October 11, 2014

Ezekiel Emanuel’s Latest Rant

Editor’s note. This essay appeared at truedignityvt.org.

Ezekiel Emanuel, an architect of ObamaCareEzekiel Emanuel, an architect of ObamaCare
Ezekiel Emanuel has spent his life building an impressive resume and now, at age 56, he wants the world to know that by 75 he plans to stop working so hard. In fact, he says that if he is still alive at 75, his master plan is to “stop all medical treatment” with the goal of avoiding such horrors of old age as frailty and forgetfulness. Emanuel told Judy Woodruff on PBS News Hour October 3 that he doesn’t believe in assisted suicide or euthanasia, and yet he also said he doesn’t want his grandchildren to “remember me as frail, or demented, or repeating myself—that would be a tragedy.” One wonders what he will do if stopping medical treatment doesn’t bring the hoped-for results.

It is very hard to take nonsense like this seriously, even when it comes from a bioethicist –physician with impressive credentials—and one who helped develop the Affordable Care Act. His views are fleshed out more clearly, though no more reassuringly, in an Atlantic Monthly article published last month.
Unfortunately, his position has a following and must be taken seriously. Emanuel claims that he has heard from scores of people who agree with his views, and says that “at least 50 percent of them are in the health care professions.” (Now that is something to take seriously, especially if you are looking for a health care provider after age 75.)

Although he stops short of saying he thinks all people should eschew medical care after age 75, the implication is clear. In Emanuel’s opinion, once you are no longer a creative, contributing member of society, you owe it to yourself and others to check out, sooner rather than later. His definition of creative and contributing, by the way, appears to be narrow and limited. It could be argued that many of today’s able-bodied Americans would not meet his criteria, never mind those who are physically or mentally challenged in some way.

He told Woodruff that he disagrees with those who have “made a religion” out of pursuing longevity, through obsessive diet and exercise regimens, as if that extreme is the only alternative to his approach.
What about a third way? What about re-thinking the way we look at aging, and more than that—the way we treat the aged and disabled? To hear the Ezekiel Emanuels of the world tell it, the post-75 years are a frightening morass of physical and mental disability best avoided if at all possible. And yet it is easy to find countless examples in everyday life of people who live meaningful lives with the “frailties” that Emanuel wishes to avoid.

Perhaps the experience of aging is as much colored by the attitudes of the people that surround an individual as it is by that person’s objective physical and mental condition. When the people who love you actually love you and not your resume alone, when the people around you treat you as an individual of worth and not primarily a life to be judged, a burden to be carried, or a problem to be solved, you are more likely to tread more easily into the twilight years.

Each stage of life brings challenges different from the one before, and the last stages of life certainly can bring the physical and mental declines Emanuel talks about. But, not unlike the fall colors that are quickly disappearing from our landscape today, being “past peak” doesn’t mean being without value.

Discovering that meaningful life continues even when you aren’t the center of attention can be a difficult lesson for high achievers like Emanuel, but it’s one worth learning.