Doubtless, death is a loss. It deprives us of experiences and milestones, of time spent with our spouse and children. In short, it deprives us of all the things we value.
But here is a simple truth that many of us seem to resist: living too long is also a loss. It 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, even pathetic.
Americans seem to be obsessed with…a valiant effort to cheat death and prolong life as long as possible. This has become so pervasive that it now defines a cultural type: what I call the American immortal.
I reject this aspiration. I think this manic desperation to endlessly extend life is misguided and potentially destructive. For many reasons, 75 is a pretty good age to aim to stop….
Isn’t this Rahm Emanuel’s brother and the author of the Affordable Health Care Act? Hmmmmm.
1. Yep, same one. Be sure to check the fine print.
Dr. Emmanuel published an article in the British medical Journal The Lancet in January 2009 in which he and his co-authors advocate a system that denies health services to older people – he actually has developed a curve shoeing who should get medical services and who should be denied!!
Here is the link to the article:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60137-9/fulltext
Under Medicare, some procedures are already being denied because of age. All they have to do is increase the number of age prohibited procedures until the only thing left is the annual flu shot.
I should add that I’m 76. Already past the “sell by date” according to him.
The link I provided above does not work. Here is a link that works:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60137-9/fulltext
To read the full article you have to register – it is free.
Sorry Marie: the chart in his article stops at age 75–so you are off the chart!!
Let it be noted that the Lancet article is entitled [i]Principles for allocation of [b]scarce[/b] medical interventions[/i] and the abstract specifies organs and vaccines. In other words, this isn’t advocacy for the discontinuation of all but palliative care for the over-75s (in this article he suggests this as a course that he himself is voluntarily pursuing) but a suggestion that age and life-expectancy are factors to be weighed in the balance. If you have one organ and several candidates, there’s always something of a judgment of Solomon involved and I suspect most transplant surgeons already take life expectancy into account, but can you can really treat it as some sort of manifesto to eliminate the elderly as a class?
#7–The difference is that under Obamacare an over bearing Federal Government will now decide who lives and who dies. The ACA already has the mechanisms built in to accomplish this end, and hospitals have the incentive to let older and sicker people die. The very things that were dumped on Paul Ryan by the Dems in 2012 political ads, are the very things, and worse, that the Dems put in there (without reading it, of course). And the elite government class will assuredly exempt themselves and their relatives. I will GUARANTEE you, when Mr. Emmanuel actually faces death his desire for narcotics only will evaporate and he will be begging his brother to make a phone call to get him whatever care is necessary.
I wonder if he will start smoking, drinking, and living dangerously till then?
David (#7),
That may or may not be true, but the article cited does not refer to rationing of all non-palliative care, but the allocation of a finite resource – we can surely all agree that transplant organs are finite. Maybe Emmanuel has written elsewhere of denial of non-palliative care in which case he should be called on that, but don’t we make a point here about judging people based on what they say not on our perception of them?
No point in getting into a you know what contest. Let’s just agree to disagree about the Emmanuel brothers.
#10, the distrust here begins with Mr. Obama himself, who famously told a voter that perhaps her grandmother (in excellent general health, but 90-something) should forego an operation on a joint (as I recall) and just take pain killers. Some people in their 80s and 90s would benefit from surgeries and enjoy several more good years, while some are too frail or ill to benefit. These decisions, critics say (and I say) should be made depending on the circumstances by the patient and physician and not according to government age charts.
Katherine,
I happen to agree with you (and I don’t think that ACA as it stands is that well-crafted a piece of legislation), However, I also note that critics of ACA are very quick to argue in respect of many of ACA’s mandates for minimum care (and I don’t just mean birth control) that there’s no such thing as a free procedure – somebody has to pay for it – and why should one class be responsible for the health care choices of another class. Granting that premise, the decisions about treatment of the elderly become contingent on whether they personally can afford to make them – either out of their own resources or through the insurance plan to which they subscribe.
One can be as suspicious as one likes about the priorities of federal bureaucrats but that doesn’t mean that insurance companies won’t make choices that are grounded in cost-benefit analysis and I’m guessing that nobody here would suggest that the extent of end-of-life care should be wholly contingent on one’s economic success in life (several T19 comentators, after all, despite long and dedicated careers, would not seem to be particularly well off).
One of the interesting things about being back in the UK, with an American wife who’s a health care professional, is that it’s thrown a whole new light on the NHS. I can see much better how antiquated much of the machinery is compared with the US, but there remain aspects of it that are much better than their American equivalents (my wife can vouch for this), just as there are things about which I’m far from proud. What would be nice would be if the Christian community could find a way to cut through the ideological positions that color the health care debate and actually acknowledge the deficiencies of both extremes. I still live in hope.
Jeremy #13: Thanks.
Regarding the actual article and argument, it shows a lack of understanding of why life is important. The article argues that since creativity and activity slow, and because he doesn’t want to be remembered as old and decrepit, he will forgo even normal preventative care (flu shots, etc) after 75.
My dad died a year ago at age 93. His life between age 75-92 was profoundly productive despite fairly serious health issues: he retired for the fourth time; served on boards, did lawyer-CPA pro bono work; travelled up and down the East Coast (driving himself very competently until he was 90); grew spiritually; and spent time with his wife, children and grandchildren who adored him. Would not trade ANYTHING for that time with him. I understand arguments about quality of life but even in his final illness, we treasured every moment with him. To have written him off at 75 — what a loss that would have been!
Zeke, you go dude. Why wait until 75?
Leonard Cohen says that, now that he’s turned 80, he’s going to start smoking again.
Here’s hoping that that he finds time to finally decipher for some of us the inscrutable lyrics to his otherwise very pleasing songs, e.g. from “Hallelujah”:
Maybe there’s a God above
But all I’ve ever learned from love
Was how to shoot at someone who outdrew you
It’s not a cry you can hear at night
It’s not somebody who has seen the light
It’s a cold and it’s a broken Hallelujah
:>}