A doctor and medical ethicist argues life after 75 is not worth living

Thursday, August 29th, 2019

In October 2014, Ezekiel Emanuel published an essay in the Atlantic called “Why I Hope to Die at 75.” Because Emanuel is a medical doctor and chair of the University of Pennsylvania’s department of medical ethics and health policy, as well as a chief architect of Obamacare, the article stirred enormous controversy.

Emanuel vowed to refuse not only heroic medical interventions once he turned 75, but also antibiotics and vaccinations. His argument: older Americans live too long in a diminished state, raising the question of, as he put it, “whether our consumption is worth our contribution.”

Emanuel was born into a combative clan. One brother, Rahm, recently completed two terms as the controversial mayor of Chicago; another brother, Ari, is a high-profile Hollywood agent. But even given his DNA, Emanuel’s death wish was a provocative argument from a medical ethicist and health-care expert.

Emanuel, now 62, talked with me about the social implications of longevity research and why he isn’t a fan of extending life spans. I was particularly curious to get his reaction to several promising new anti-aging drugs.

Q: It’s five years since you published the essay. Any second thoughts as you near the deadline?
A: Not really! [Laughing]

Q: You announced that you wouldn’t take any measures to prolong your life after 75. Isn’t that an extreme position?
A: First of all, it’s not an extreme position. 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.

Q. But it’s called “Why I hope to die …”
A. As you probably know better than everyone else, it’s editors that choose titles and not authors.

I often get, from the people who want to dismiss me, “You know, my Aunt Nellie, she was clear as a bell at 94, and blah-blah-blah …” But as I said in the 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.

Q: You suggest that one effect of our obsession with longevity is that it diverts attention from the health and well-being of children.
A: 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. Continue reading