Life ends at 75?

Earlier this fall, I read Stephen S. Hall’s interview with Dr. Ezekiel Emanuel published in the MIT Technology Review. Emanuel, an oncologist, bioethicist and chair of the University of Pennsylvania’s Department of Medical Ethics and Health Policy, as well as chief architect of Obamacare, stirred controversy with his 2014 article in The Atlantic titled, “Why I Hope to Die at 75.”

Emanuel, 62 at the time of the interview, said in his essay that he vowed to refuse heroic medical interventions, antibiotics and vaccines to extend his life when he reaches 75.

Why, I wondered, would an educated man of medicine living in a nation where the average male life expectancy today approaches 79 embrace such a radical philosophy?

(Then I discovered he’s the brother of Chicago’s controversial former Democrat

Mayor Mayor Rahm Emanuel.)

The doctor, a senior fellow with the Center for American Progress, said he believes, in general, that Americans are living too long in a diminished condition, which for him raises the question of “whether our consumption is worth our contribution.”

At 72 myself, his approach to departing this world took me aback. I’m not at all certain I’ll have exhausted my contributions in another three years. While my body is feeling the natural effects of passing decades, I still feel 35 in other ways. I’m betting many in their late 60s and beyond would share that opinion.

I regularly play golf with men around 80 who can still shoot their ages and enjoy the challenge. Bernie Sanders is 78 and running for president. Clint Eastwood at 89 is still contributing with first-rate films, and Ruth Bader Ginsburg, 86, for now remains a contributing member of our Supreme Court, despite medical setbacks of late.

Emanuel told Hall he didn’t consider his plan extreme. “I’m not going to die at 75. I’m not committing suicide. I’m not asking for euthanasia. I’m going to stop taking medications with the sole justification that the medication or intervention is to prolong my life.”

He said he has heard plenty from those who dismiss his views with anecdotes: “‘You know, my Aunt Nellie, she was clear as a bell at 94, and blahblah-blah’ … But as I said in the [Atlantic] article, there are outliers. There are not that many people who continue to be active and engaged and actually creative past 75. It’s a very small number.”

The doctor took his point a step further. “Lots of presidents and lots of politicians say, ‘Children are our most valuable resource.’ But we as a country don’t behave like that. We don’t invest in children the way we invest in adults, especially older adults. One of the statistics I like to point out is if you look at the federal budget, $7 goes to people over 65 for every dollar for people under 18.”

Emanuel said if anyone could design the life they wanted, he believed people initially would choose to keep going as rapidly for as long as they can and “just fall off a cliff.” But he said they’d reconsider and say they didn’t want to “die of a heart attack or stroke in the middle of the night.” They would “want to say goodbye to my family. So I want some gentle decline, but a very short amount of time. You know, months, not years.” Emanuel told Hall he’s basically no different and would prefer to maintain his energy, intellect and productivity right to the end. “But I think we also need to be realistic—that’s not the way most of us are going to live.” What he said he sees as a physician are people living longer but with more disabilities and diminished cognitive abilities.

There aren’t that many highly intelligent people “writing brand-new books after 75, and really developing new areas where they are leading thinkers. They tend to be re-tilling familiar areas that they’ve worked on for a long time,” Emanuel explained.

“I do fear death. But I think I fear being sort of decrepit and falling apart more.”

Emanuel’s point set me to thinking about the years that may, or may not, lie ahead for me. And while I understand his point about productivity after 75, I also believe many among us will have earned whatever time we choose to enjoy family and friends as our production capacity diminishes.

Chronological age to me loses significance when we consider our individual life circumstances. Which flawed bureaucrats (medical or otherwise) should choose who is continuing to contribute enough of whatever to continue aging?

In other words, this debate over longevity measured by a sustained productive purpose in life for me is indeed radical and far from being a one-size-fits-all proposition.

Besides, I don’t agree, as Emanuel seems to imply, that we were placed in this world primarily to see how much we can produce and contribute outside of love, empathy and genuine compassion for one another. Food for thought, valued readers.

Now go out into the world and treat everyone you meet exactly how you want them to treat you.