“Why I Hope to Die at 75”

old-woman-1435250Ezekiel “Zeke” Emanuel recently wrote an interesting article in The Atlantic headlined, “Why I Hope to Die at 75.” It is worth the read especially if you are approaching 75 or have parents or grandparents that age. Emanuel is a doctor, bioethicist, and older brother of the mayor of Chicago. http://www.theatlantic.com/features/archive/2014/09/why-i-hope-to-die-at-75/379329/

His basic premise is that by 75 “creativity, originality, and productivity are pretty much gone for the vast, vast majority of us” we no longer leave behind a legacy of vibrancy and engagement, but of feebleness and frailty. Not only do we heap upon our children additional emotional and financial burdens, but we leave them and our grandkids with “memories framed not by our vivacity, but by our frailty.” He calls that “the ultimate tragedy.” Therefore, he does not wish to live beyond 75.

He does not advocate for euthanasia, but it is his plan (he is now 57) that if he lives to 75 he will not prolong his life. “At 75 and beyond, I will need a good reason to even visit the doctor and take any medical test or treatment, no matter how routine and painless. And that good reason is not ‘It will prolong your life.’ I will stop getting any regular preventive tests, screenings, or interventions. I will accept only palliative—not curative—treatments if I am suffering pain or other disability… This means colonoscopies and other cancer-screening tests are out—and before 75. If I were diagnosed with cancer now, at 57, I would probably be treated, unless the prognosis was very poor. But 65 will be my last colonoscopy. No screening for prostate cancer at any age… After 75, if I develop cancer, I will refuse treatment. Similarly, no cardiac stress test. No pacemaker and certainly no implantable defibrillator. No heart-valve replacement or bypass surgery. If I develop emphysema or some similar disease that involves frequent exacerbations that would, normally, land me in the hospital, I will accept treatment to ameliorate the discomfort caused by the feeling of suffocation, but will refuse to be hauled off… Flu shots are out… no to antibiotics… Obviously, a do-not-resuscitate order and a complete advance directive indicating no ventilators, dialysis, surgery, antibiotics, or any other medication—nothing except palliative care even if I am conscious but not mentally competent—have been written and recorded. In short, no life-sustaining interventions. I will die when whatever comes first takes me.”

While I agree with him about the American obsession with living forever, he falls off the other side of the saddle with his American obsession with control. He sees the 18 years that he has left (as if he is in charge) as a self-imposed deadline so that he can get done the important things in life before he begins his inevitable decline. He is also dismissive of any faith perspective that would be used to rebut his view. “I also think my view conjures up spiritual and existential reasons for people to scorn and reject it. Many of us have suppressed, actively or passively, thinking about God, heaven and hell, and whether we return to the worms. We are agnostics or atheists, or just don’t think about whether there is a God and why she should care at all about mere mortals.” He seems to make a life of faith seem more like a knee-jerk reaction to our mortality rather than well-intentioned choice in view of our creatureliness and frailty. He also completely overlooks the positive impact that our suffering can have in the development of our children and grandkids.

There is an arrogance embedded in this article which belies the name of the author; Ezekiel (means his strength is in God). The prophet was keenly aware of God’s presence and power in human affairs. He suffered captivity and the very death of his own wife, but prophesied a message of hope and reassurance for the people of Judah. There was one thing that the biblical Ezekiel knew for sure: God is in control and we must humble ourselves before him. And in this relationship of submission, humility, and trust regardless of life’s circumstances, we find our greatest usefulness.

“Lord, teach me to number my days that I might apply my heart to wisdom” (Ps. 90:12).