Published in Pawtucket Times, December 12, 2014
Dr. Ezekiel Emanuel, MD, Ph.D., a nationally-recognized oncologist and bioethicist, definitely marches to a different drummer. While millions of older Americans pop Vitamins and supplements like M&M Candy, regularly exercise at their local gym, religiously jog and carefully watch what they eat to increase their life span, the chair of medical bioethics and health policy at the University of Pennsylvania, says living past the ripe old age of 75 is not on his bucket list. We would be doing both society and our loved ones a favor by agreeing with this belief, he says.
When I am 75…
Why not age 80 or even 85? Emanuel admits that his 75th birthday day was just a randomly chosen number, but the year was selected because scientific studies indicate that increases in physical and mental disability occur around this age, as well as a decline in both creativity and productivity.
The renowned 57-year old breast oncologist is at the top of his professional game. Emanuel has received dozens of awards from organizations such as the National Institutes of Health and the American Cancer Society, including being elected to the Institute of Medicine (IOM) of the National Academy of Science, the Association of American Physicians, and the Royal College of Medicine (UK). Hippocrates Magazine even selected him as Doctor of the Year in Ethics.
Emanuel is a prolific writer, editing 9 books and penning over 200 scientific articles. He is currently a columnist for the New York Times and appears regularly on television shows including Morning Joe and Hardball with Chris Matthews. .
The prominent physician, is also considered a key designer of the Affordable Care Act (commonly called Obamacare). At a personal level, he has two well-known brothers, Chicago mayor Rahm Emanuel, former White House chief of staff, and Hollywood agent Ari Emanuel.
With this prominence, Emanuel’s death wish to die at 75, (the year 2032) before the onset of Alzheimer’s disease and other dementias, and decreased physical stamina (it’s harder to walk a quarter of a mile, even to climb 10 stairs) is drawing the ire of critics who charge that he advocates for health care rationing and legalized euthanasia.
But Emanuel claims that these charges are not true. Setting his death at 75 is just his personal preference, he says, leaving his mortal coil. In his writings and media interviews he notes that setting the age when he hopes to die just drives his daughters and brothers crazy.
Last October, at the BBC Future’s World-Changing Ideas Summit in Manhattan, Emanuel’s prop, a full-page AARP ad from a newspaper, featuring an older couple hiking above a line of text that read, “When the view goes on forever, I feel like I can, too. Go long.” Reinforcing his point, Emanuel is not buying AARP’s message pushing the positives of living an extended life. For him, he doesn’t buy it and most definitely, seventy is not the new 50.
Sharing a Death Wish on the Air Ways
On Dec. 7, on CBC Radio Canada’s Sunday Edition, Emanuel, discussed his controversial October 21, 2014 article published in the The Atlantic, “Why I Hope to Die at 75.” His Sunday interview detailed his unconventional and controversial stance, especially to AARP, the nation’s largest aging advocacy group, and aging organizations who strongly oppose this type of thinking.
Throughout the 28.12 minute interview with Michael Enright, Emanuel, he warns listeners, “Don’t focus on years, and focus on quality.”
“A good life is not just about stacking up the years and living as long as possible. People need to focus on quality of life,” says Emanuel, noting that “Setting an actual date for a good time to die helps you focus on what is important in your life.”
“It is really about what you are doing to contributing and enriching the world. I want people to stop focusing on just more years, focusing on quality,” he says.
Emanuel says that you need to be realistic on living forever, your body and mind doesn’t go on forever. You should just be satisfied with living a complete life, he says.
By age 75, people will have gone through all stages of life, says Emanuel. As a child you begin to develop skills and figuring out your place in the world. You go to college, raise a family, work to hone your skills and talents. At the later stages of your life you give advice and mentor people, he says, noting that in your mid-seventies, physical deterioration and mental slowing along with loss of creativity, begin to be felt.
During his radio interview, Emanuel claimed he is very active, recently climbing Mount Kilimanjaro with is two nephews, stressing that he is in relatively good health and doesn’t have a terminal illness and has no plans to commit suicide. As a matter of fact, the physician even condemned physician-assisted suicide and euthanasia, in a 1997 article published in The Atlantic, a policy allowed in the states of Oregon, Vermont and Washington. His philosophical view of ending one’s life is to allow the body to age naturally, he stresses.
In eighteen years, Emanuel pledges to refuse all medical procedures and treatments, including taking medications such as statins, cholesterol lowing drugs, and antibiotics that could prevent life-threatening illnesses or extend his life. He notes that his last colonoscopy will be at 65, to screen for cancer. No more colonoscopies after 75. And, he’ll only accept palliative care after that milestone age, too.
“I’m not suggesting people kill themselves at 75 but, rather, let nature take its course,” Emanuel says.
How Others See it
Emanuel’s personal preference not to seek medical procedures or to use medications at age 75 that might lead to his death is not the same as physician assisted suicide, says Rev. Christopher M. Mahar, S.T.L., of the Providence Catholic Diocese, noting that this choice has always been respected by the Catholic Church.
“He is not actively choosing to take his life, and as long as he is not rejecting any of the ordinary means necessary for the preservation of life, such as nutrition and hydration, and is not intentionally destroying his body, he is free to decide for himself, says Mahar.
As Emanuel says, there is a downside to aging. My 88-year-old mother died after a 14 year battle with Alzheimer’s disease. At age 89, my father, whose quality of life declined over his later years, died suddenly, by having a pulmonary embolism.
For me, 89 is the year I choose to meet my maker, hanging up my spurs. Yes, I will let nature take its course, but I will most continue to take Vitamins and antibiotics, even my Lisinopril, for high blood pressure. I will not turn my back on medical procedures or technology that might enhance the quality of my life, even lengthen it.
I agree with the statement of late Actress Betty Davis stated, “Old age ain’t no place for sissies.” There is no alternatives, you can only hope for nature to ultimately take its course, and it will. And so, we all are inclined to pick our own magic number.
Herb Weiss, LRI ’12, is a Pawtucket writer who covers aging, health care and medical issues.