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October 6, 2014

Physician-ethicist Ezekiel Emanuel seems to love being at the center of controversy. One of the architects of Affordable Care Act, he is director of Clinical Bioethics at the NIH and chairs the Department of Medical Ethics & Health Policy at U Penn. He has frequently (and often unfairly) been criticized for pointing out the flaws in our current health care system, which he describes as  “truly dysfunctional” (Wash. Post). Worse of all, many think of him as a real utilitarian pragmatist, and have accused him of trying to ration health care. He has denied this.

So it comes as a bit of a shock to see Emanuel’s latest article in the Atlantic, “Why I Hope to Die at 75.” He claims that he will stop using the health care system at age 75. He puts it this way:

[H]ere is a simple truth that many of us seem to resist: living too long . . . 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 (source below).

Emanuel goes on to say that this is no death wish, but he feels that he may no longer be productive and enjoy things at age 75. So he hopes that will be the end. If he has cancer or develops pneumonia, he will refuse chemotherapy or antibiotics. His last colonoscopy will be at age 65. And when he hits 75, no flu shot.

Why this somber navel-gazing with 18 years to go?  What is Emanuel trying to prove? He is implying, I think, that there is no more to life than our contributions to society. He is subtly saying that older patients are selfish to use so many health care resources, and that we should all just forget about living long lives. Ah, but that of course is the ultimate lie that so many functionalists would have you believe. We are valuable because of what we do, not for who we are.

On the other hand, the Christian view of the human person teaches that we are valuable for our own right. Each of us was made “a little lower than God,” and our Creator has crowned us “with glory and majesty” (Psalm 8:5, NASB). The elderly deserve honor; they have the right to enjoy the fruit of their labor. Our value is intrinsic, and does not depend on our age or our abilities.

Don’t let a pontificating utilitarian make you feel guilty for living out the full lifespan that God has allotted you.

Article in The Atlantic

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