Dr. Ezekiel Emanuel - Rahm's brother comes under fire for ethics on view of people over 75, no value

[TheNutcracker]

"People become less creative as they age. It forces each of us to ask if our consumption is worth our contribution."

75 years and no medicine if you need it????
WHAT????? So old people have no value as contributors? What about as parents? Mine are still good listeners to all of us, even though they are much older than 75. Are they as creative as they used to be? No, they are aging, and doing their best to maintain. They love life and mother Earth.

Fuck you Dr. Emanuel! Why would Obama have you anywhere as a policy advisor????
http://www.pbs.org/newshour/bb/doctors-argument-living-longer/

JUDY WOODRUFF: Next: a provocative piece of writing from one of the country’s leading health care experts.

In the current “Atlantic” magazine, Dr. Ezekiel Emanuel argues that the quality of human life begins to drop off by age 75, enough, he says, that he will opt out of medical treatments and let nature take its course.

A trained oncologist, Dr. Emanuel is chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, and a former Obama administration policy adviser. He is also older brother to Chicago Mayor Rahm Emanuel and Hollywood talent agent Ari Emanuel. I sat down with him earlier today.

Dr. Zeke Emanuel, thank you for talking with us.

DR. EZEKIEL EMANUEL, University of Pennsylvania: It’s my great pleasure.

JUDY WOODRUFF: So, you have created quite a stir: “Why I Want to Die at 75.”

Why 75? Why not 85? Why not 70?

DR. EZEKIEL EMANUEL: Well, first of all, let’s clarify, I expect to be alive at 75, and I’m not going to kill myself. I don’t believe in legalized euthanasia or assisted suicide, but I am going to stop medical treatments.

And I look at 75, when I look at all the data on physical disability, dementia, Alzheimer’s disease, loss of creativity, slowing down of the mind and the body, and 75 seems like that, albeit somewhat arbitrary, moment where you get the maximum chance you’re still going to be vital and alive and vigorous.

JUDY WOODRUFF: So it’s kind of arbitrary.

DR. EZEKIEL EMANUEL: I say that, yes.

JUDY WOODRUFF: And you talk about something you call the American immortal. Who is this being?

DR. EZEKIEL EMANUEL: My brother. The American immortal are people who want to put off death as long as possible, want to live as long as possible, get every day out of it. They take all these — they change their diet. They exercise like mad. They take protein concoctions and all sorts of other supplements.

And it’s almost a religion for them to live as long as possible. And I think they — in their mind, they will be as vital as they are when they’re, say, 50 all the way to the end. But, of course, we all do deteriorate, we all do slow down, we all do get disabilities.

JUDY WOODRUFF: You looked at a lot of research for what you have written, and you talk about how, as you age, you really don’t get healthy. No matter how hard you try, a lot of things creep up on you.

DR. EZEKIEL EMANUEL: Yes, so there’s a theory which was developed in the early 1980s at Stanford, of course, that there will be a compression of morbidity.

So, as we age, as we get older, we are actually going to become healthier, that the falling apart, the disabilities, the dementia, they’re going to become ever smaller parts of life. And that was a very, very compelling theory, and a lot of people grabbed on to it.

Turns out that’s not true. The data are that, as we age, we have actually added more years of disability, so there’s not a compression of morbidity. There’s actually been an expansion, and that I think is — it’s somewhat distracting for people to realize, yes, we will live longer, but we will also live with more functional limitations, less able to move around, more mental limitations, more psychological depression, and other mental problems.

JUDY WOODRUFF: You put — you’re pretty critical in this piece, Zeke Emanuel, of slowing down, of living a quieter life, of spending time smelling the roses.

(LAUGHTER)

JUDY WOODRUFF: You talk about riding a bicycle and making poetry as if it’s just, you know, a throwaway. What’s wrong with having that quiet phase of life after a certain point?

DR. EZEKIEL EMANUEL: I do — I mean, that is part of my view, that, you know, we’re on the earth for a very short period of time, no matter what we do. Even if we’re an American immortal, it’s not going to be for centuries.

And we have to get the best out of it and also get the most out of our life. It’s a privilege, obviously, slowing down and being a little sort of self-indulgent. I don’t find that as meaningful to me. And I find it a little sort of focused on me, instead of focused on what I can contribute and what I can do for bettering the world and bettering, you know, my family and my community.

JUDY WOODRUFF: So, you’re kind of saying unless you’re contributing actively every minute of every day, practically, then really there’s not much point in living?

DR. EZEKIEL EMANUEL: Well, first of all, that’s my personal philosophy. And I do believe that contributing can happen in a number of different ways.

JUDY WOODRUFF: You know there’s a lot of pushback from people who point to all the people we know of who are very contributing well beyond 75.

I just look — you look at anywhere you turn. I mean, in the world of entertainment, it’s so easy, the Jack Nicholsons, the Willie Nelsons, the Sidney Poitiers. I mean, Betty White is 91, I.M. Pei. Queen Elizabeth is 88. Jimmy Carter just turned 90.

DR. EZEKIEL EMANUEL: So, that’s almost everyone’s first reaction is to begin listing lots and lots of people who are over 75 and still creative, productive and engaged. And of course there are going to be people.

It’s a bell-shaped curve and it’s some-shaped curve, there are going to be outliers, people over 75. But let’s remember we live in a country of 300 million people. In the developed world, Western world, there may be a billion people. Giving me a list of 20, 30, even thousands of people who are creative after 75, you have to understand those are very select outliers.

They are not the common thing. And I believe that we shouldn’t — we can’t live our life as if we’re going to be a very rare outlier. Odds are, you won’t be an outlier, and I tend to go with the odds. I’m a sort of — I live life by, you know, what does the data show? And that’s most likely to happen.

JUDY WOODRUFF: What does your family think about this? You have how many daughters?

DR. EZEKIEL EMANUEL: I have three daughters.

JUDY WOODRUFF: Three daughters. Don’t you want to see your grandchildren grow up?

DR. EZEKIEL EMANUEL: Absolutely. And I want…

JUDY WOODRUFF: But you have put kind of a limit on it, haven’t you?

DR. EZEKIEL EMANUEL: Well, I am very, very committed to seeing my grandchildren.

more at link if you can stomach it!

[TheNutcracker]

1. K&R for embarrassment purposes! This should have more exposure!

[kcr]

29. I remember when this story first broke. I didn't know he was Rahm's brother.

That explains so much. Especially the comments about his brother.

[djean111]

2. Yes. For those who said hey! I (or my friend) am 75 and still golfing!

That does not count, because you are not contributing creatively.
You ARE contributing to the economy, though.

[dilby]

3. In other words he thinks people are here to work for the system and

not the other way around where it should be the system is there to work for the people.

[enlightenment]

4. I think it's funny.

Why?

Because Dr. "medical ethics" Emanuel apparently can't see the disconnect between:

"Well, first of all, that’s my personal philosophy . . ."

In other words, 'this is what I think. My belief structure. My opinion.'

and

"It’s a privilege, obviously, slowing down and being a little sort of self-indulgent. I don’t find that as meaningful to me. And I find it a little sort of focused on me, instead of focused on what I can contribute and what I can do for bettering the world and bettering, you know, my family and my community."

He published an article on the topic of his personal philosophy, which has served one purpose. It has focused attention on him. On his personal opinion. His belief structure. The article doesn't contribute to "bettering the world" - it is doubtful that his daughters feel that it has "bettered" his family . . . but it has certainly focused the spotlight on him and given him a platform to expound - at length and repeatedly - on his personal philosophy.

For someone who finds that personal focus on him a "little sort of self-indulgent" and not as "meaningful" he certainly seems to be enjoying his 15 minutes.

Yet another Emanuel who is so self-absorbed that he thinks whatever drops out of his mouth is golden, regardless of how little sense it makes.

[TheNutcracker]

6. Why is someone so "disconnected" advising the President on health care policy?

[enlightenment]

18. He's not doing that anymore.

I suspect it was the standard nepotism of politics at play when he did advise - since he's Rahm's big brother.

[bettyellen]

16. ^^ THIS^^ Plus his bizarre little swipe at his brother seems to have inspired him here, as if

proving him wrong some how is a huge part of the "philosophy" for him.

Jeeze, I could list dozens of people from 18- 60 who contribute nothing cretively, people who screw up everything they touch.
Should we just let them whiter and die too?

[dixiegrrrrl]

26. Yeah....I caught a lot of cognitive dissonance in his words..

It sounds like what he is trying to say, but doesn't want to really say, is ....old age is fine for me, but not for those "other people" once they stop working.

[beerandjesus]

5. Did anyone other than me actually read that Atlantic article?

It's very thought-provoking. That's it. That's all it's intended to be.

He's very clear that he's not advocating anything, only that he's made a decision for himself that, he recognizes, is pretty far outside the mainstream. For that reason, he explains his thinking..... and that's it.

[TheNutcracker]

7. Again, why then are the bat shit crazies advising the President?

[muriel_volestrangler]

10. 'Bat shit crazy'? That's a kneejerk reaction if I ever saw one

It's his viewpoint of what he thinks he'll get from his old age - or not. Do you think attempting suicide should be illegal, perhaps?

[suffragette]

19. Well, no idea about OP's view, but Emanuel thinks it should be illegal

Last edited Wed Nov 12, 2014, 03:14 PM - Edit history (1)

and he has written that U.S. policy should be to keep it illegal.

http://www.theatlantic.com/magazine/archive/1997/03/whose-right-to-die/304641/?single_page=true

The proper policy, in my view, should be to affirm the status of physician-assisted suicide and euthanasia as illegal. In so doing we would affirm that as a society we condemn ending a patient's life and do not consider that to have one's life ended by a doctor is a right.

He does note there should be exception to that in extreme cases.

This is from an older article, which he wrote in disagreement with the 2nd and 9th Circuit Court decisions "striking down state laws in New York and Washington that forbid physician-assisted suicide."

Glad I live in Washington State, where after the 9th's decision we voted for a Death with Dignity law. Also glad his influence didn't extend to affecting that, though I am troubled by the influence he does have.

[muriel_volestrangler]

22. I was thinking about whether the thread starter wanted the person themselves prosecuted

for attempting suicide, rather than anything about assisted suicide, since what Emanuel is proposing is that he himself will refuse everyday medical treatment after 75. TheNutcracker seems to think this is 'bat shit crazy'.

[suffragette]

25. I read that as TheNutcracker being concerned at the influence Emanuel has on policy here

I have no issue with Emanuel's private views. But he has shown a tendency to extend these to public policy. And he has access to people who create that policy. That I have issue with.

[Ampersand Unicode]

23. Why should it remain illegal?

My body, myself. Death happens no matter what; why shouldn't a person have the choice to snip the threads of fate when they choose instead of waiting for "natural causes" or "God" to take them?

Do you feel this way about abortion also? That's the only other bodily-autonomy issue I can think of that is so controversial.

I'm 18. I contribute zilch creatively or to the economy (and more and more, the two are looking mutually exclusive). I will probably never contribute anything either way. I could go on again about how liberal-arts majors don't do anything but make burgers for minimum wage. Much as I think it should be raised, even if you made six figures flipping burgers, you're still nothing but a lowly burger flipper. Who wants to be condemned to a life of menial shift work? I don't. Sadly, I probably will be, because I can't do math and the only good-paying jobs other than high-priced call girl or professional assassin are STEM jobs. There's no money in writing; there's no money in art; there's no money in music; there's no money in whatever it is I do when I'm looking up boring shit to write a term paper (I believe this is called academic research). Basically there's no money in anything that doesn't involve high-skilled math courses and an almost entirely left-brain number-processing capability.

I have already made the choice to die because my life is worth nothing. I'm basically what you might consider "occupationally disabled," as in, I'm not sans limbs or hearing voices or rubbing shit on the walls, but neither can I do much of anything that would earn me enough money to make end's meet. All I can do is write an A paper on comparisons between the populist and ill-fated Gracchi brothers in ancient Rome and John and Bobby Kennedy for a history class. Know how many sesterces that earned me? Zero. Know how many I was able to give to the economy for it? Zero. Big fat nulla.

The college's career center has already said to me that they don't like to deal with humanities students because they are so hard to find jobs and internships for. I got the bum's rush because nobody wants them. The advice I got from a career counselor was to switch to a STEM major. I said I can't, for the life of me, do math. Her response was to print out an application to Macy's with a smug, "They're hiring for the holidays. Maybe it'll turn into a permanent job."

TL;DR: Emanuel is right. Why should anyone be forced to live a meaningless life if they know, and are ashamed of the fact, that they "contribute nothing"? I say bring on the death panels because I want to be the first to sign up!

[suffragette]

24. You completely misread my post and reversed the views of myself and Emanuel

[treestar]

39. "meaningless" is subject to interpretation

lots of burger flippers would tell you to piss off.

[beerandjesus]

11. Sounds like a No.

[hobbit709]

17. But they're OUR batshit crazies as opposed to THEIR batshit crazies.

And ours are to be accepted without criticism.

[Ampersand Unicode]

27. Wow, just a few weeks ago people on this board were all for this.

Bodily autonomy in the Brittany Maynard case. But for everyone else who isn't terminal and just wants to make a conscious choice, tough shit bro, you have to suffer because every life is sacred, every life is great, if ever a 99%-er is wasted, Marx gets quite irate?

Why shouldn't euthanasia and assisted suicide be legal for EVERYONE regardless of "justifiable cause"? Robin Williams had a shitload of problems when he brutally hanged himself with a belt. You think he should have kept calm and carried on?

How about people who are just tired of the shit that this world deals them and would rather die than live miserably as pawns in this sick game of paycheck-to-paycheck? The woman in New Jersey who worked 4 Dunkin' Donuts jobs: what if her death wasn't an accident and she just decided she was tired of working 4 Dunkin' Donuts jobs with no hope for upward mobility? You'd tell her to fight the good fight for all of us and soldier on? Quit all her jobs and go on public assistance? Go to college and then work 40 Dunkin' Donuts jobs to pay back student loans for a worthless basket-weaving degree?

How about people like me who are 18 and haven't even gone out into the "real world" yet but don't really see the point in bothering anymore because all that's left are Dunkin' Donuts jobs unless you're a math genius like Will Hunting and get a full ride to MIT. How about people who think that a life condemned to poverty and shift work is a fate worse than death, who vote and vote and vote for everything including dog catcher yet see no improvements in their own lives because everything is sold out to the rich and nobody really cares about the grunt behind the cash register. How about people who don't see anything noble about poverty and are realistic enough to accept that we're not all going to run out into the streets and foment another Bolshevik Revolution. Or how about people who don't even want to provide a reason and just decide they want to have control over when the threads of fate get snipped.

Why is what Emanuel is suggesting wrong? All he said was who in their right mind wants to live a life knowing they're a burden to other people? I sure don't. Heck, I don't even want to live past quarter-life because I know I'll just be a burden on the public system. I know that the 1% or the 0.01% or the 0.0000000001% or whatever the percentage of greedy SOBs at the top is called are not the ones contributing to that system and never will be. It's the guy working two or three halfway decent office jobs or construction jobs at 100 hours a week just to feed himself and his family and send his kids to college. And he's tired and he doesn't want to be burdened by everyone else because he can't be. It's killing him. Better me than him, because at least he's doing something for the greater good. He's got a skill, a worthwhile skill, whether it's operating a jackhammer or a Caterpillar or doing spreadsheets or ripping wires out of telephone poles, and he's using it for some greater good. As opposed to the worthless, no-skilled loser writing term papers about shit nobody cares about. At least if they were term papers about network infrastructure analysis or something else targeted at the job market and not Cicero or the Federalist Papers, that's one thing. But if it's bullshit for a psych degree or some other basket-weaving nonsense that leads to McDonald's and more McDonald's, then what's the use. Really, what's the use. We don't need no education. We don't need no Fryolator temperature control.

The game is rigged, and it's over. It's over for those of us who put a burden on others. It's over for those of us who contribute "creatively" but not economically. It's over for those of us who aren't Queen Elizabeth, Betty White, the Emanuel Brothers, the Jonas Brothers, or some computer genius who creates the next Mario Brothers. It's over for those of us who can write poetry but not Java Script. It's over for those of us who can play Canon in D but not program in C. It's over for those of us who can compare and contrast Dracula to Anne Rice, but who'd suck as phlebotomists. And it's high time those of us who recognize we are a burden -- people like me -- do what's necessary to alleviate some of that burden for those who do, and can, contribute. Otherwise we're -- I'm -- just dead weight, an albatross around everyone's neck. No, give me (and others) liberty: give me death. Ich bin lebensunwertens leben.

[muriel_volestrangler]

8. There was a lot of discussion about it when it was originally published 2 months ago

See http://www.democraticunderground.com/10025585759

[beerandjesus]

12. Thanks for that. Seemed strange that this would be coming up now.

[enlightenment]

20. I did.

I didn't find it thought-provoking in the slightest. It sounded whingey and utterly self-absorbed; tone-deaf and narrow-minded. Clap-trap, in other words.

Generally, when people have thoughts, they don't manage to get them published in a major magazine - or get follow up interviews on major radio and tv shows.

This guy did because of his connection to the current administration - not because he is a deep thinker.

[alarimer]

9. I think most people are misunderstanding what he actually said.

Most Medicare benefits are paid out supporting people in the last two years of life, usually for drastic measures meant to keep people alive at all costs. Should my 90 year old grandmother actually get that hip replacement, given her general infirmity at the time?

If it was me, I would have said no.

He's not saying that nobody past a certain age has value; he's making a quality of life argument. He's arguing against the idea that we should all live as long as possible NO MATTER WHAT. He's being rational and arguing that people need to be realistic. Most of us are not special or unusual in any way. We will likely not defy the odds. I don't think he is arguing for any particular policy either, at this point. Only for himself. Which may or may not hold up when that time actually comes. He's picked an arbitrary time, not knowing what the future actually holds. I think that's what has rubbed most people the wrong way. But he is not wrong.

I personally have a checklist of things I am willing to live with and those that I am not willing to live with. So, making provisions like DNRs and living wills is all a part of that too. There are certain diagnoses where I would do myself in rather than wait for the inevitable, painful end. You can tell me that's cowardly if you like, but I don't really care.

But as far as regular aging goes, there is only so much decline I am willing to put up with. And of course this may change, given advancements in technology or medicine in the decades to come.

Also, I think people should not cite Queen Elizabeth or Betty White as examples. They have way more resources than you or I do to maintain themselves. The Queen in particular has hundreds (thousands?) of staff to do all the little things that most of us have to deal with. Plus, it's kind of a cushy job, compared to most of ours. So it's probably that rich and famous people do better than most.

[Downwinder]

35. I define denial of medical treatment as torture.

Should your 90 year old grandmother live in pain without a hip replacement?

[treestar]

40. I don't think someone else should decide for the 90 year old

If they want to have the hip replacement or whatever.

As technology advances, it will all get cheaper, so it is a long term investment for professionals to do these things.

IMO it is over simplistic to value people solely as to their money making capabilities and cost.

[Nuclear Unicorn]

43. Sounds death panel-ish. nt

[aikoaiko]

13. "Hope I die before I get old" ~ The Who said it best.

[WinkyDink]

30. No; they said it glibly, cynically, for money. Do you think Daltry would trade places with Moon now?

[Exultant Democracy]

14. Well he give the average Joe 75 more years of value then Rahm does. Rahm dones't think most

people have any value at all. I'm amazed that anyone has ever voted for the guy.

[jwirr]

15. At 73 years of age I tend to agree with him on much in this article. For instance, too many people

have fallen for the idea that we are going to be able to live way past 100 years old. Every time I hear that I ask if I am going to be able to do the things I am doing right now at that age. He points out that so far that has not proved to be the case.

He also points out that there is nothing wrong with letting life take its course and enjoying what you have left of it. In other words don't worry about how productive you are going to be. Enjoy life.

Another point is that as we age we add disabilities. Anyone over 50 actually understands this. You start to ache, you get diabetes, you develop some other disease. Since the age of 50 everything has been slowly going down hill no matter how hard you work at it. It is a natural process. Every living thing has this same process. All the medical "progress" that has prolonged life and the aches is not going to change it for any of us. This is why many of us have a living will that asks that those so called miracles of science not be used.

And finally I like it where he says there are a lot of ways to contribute until the end of your life and they are part of living an active life. I find myself limiting what I can do even here on DU. I often have to ask for help from those of you who are more able. I am just thankful many of you are willing to help.

All I hear him saying here is that the theory that we are going to be able to live to 150 years old in the future is totally wrong and leading us to make some really unrealistic decisions about life.

[TBF]

21. More BS from the "third way" -

1%ers use their money to live as long as they want - while everyone else is done at 75. No more treatments.

I saw this when it first came out a couple of months ago and realized that while they are not only pushing austerity for everyone (except themselves of course), now they are just going straight for it and encouraging everyone else to just die.

This keeps getting worse and worse for those not in the 1%.

[Ampersand Unicode]

31. I don't mind doing it. Why shouldn't I?

Nothing but a waste of Pell Grants am I.
So broke and worthless, it makes me cry.
"Just get a degree" -- they sold me a lie
Now my job is to live fast and die.

Nothing but a waste of space on this earth.
I curse the worst day of my life: my birth.
I'm a hopeless fry kid just adding to the national girth.
Nothing alive or dead is what I'm worth.

Nothing but a waste of eighteen years.
A wasted vote on a few donkey's rears,
Even though the elephants are the sum of my fears.
I'm nothing but a cog in the machinery's gears.

Nothing but a waste of life am I.
So broke and worthless, it makes me cry.
I bring nothing to the table, so I must ask you why
If I live and let live, can't you live and let die?

Check spelling... Preview... Post my reply.

[TBF]

32. ...

[WinkyDink]

28. This is a very deranged and dangerous man. "I live life by the data." I don't accept his premise:

He values human beings ONLY for what they "contribute" to "society." Not simply, as with the natural world, for being.

What, I wonder, does he think HE is contributing?

[TBF]

33. Exactly - and to a society

that he and his cronies have stolen. There is something very messed up about both he and his brother.

[Nuclear Unicorn]

44. Life is imprimus. Society merely facilitates Life.

The day Life is subjugated to Society is the day we cease to be what we were born to be -- alive.

Dr. Emmanuel (what an unfortunate misnomer) has inverted the entire matter.

[Rex]

34. He is a product of the times, we live in a Throw Way society.

Sadly that mindset envelops millions of Americans. Done with my bottle of water, toss. Bank forecloses on my house, toss. There is no difference between and empty can of coke and a homeless person to far too many in America. We have become the one thing we so loath, worthless.

We value mostly superficial stuff, while ignoring the most dire stuff. Fucked up priorities.

[ladjf]

36. Classic Republican thought on the subject of aging. If you can't produce

something society deems to be valuable, then die. That's macabre thinking.

[WillowTree]

37. His views (known for some time) and his involvement as an advisor.......

.......added fuel to the whole "death panels" meme. I remember hearing quite a bit about it back when that whole thing blew up initially.

[Faux pas]

38. Thanks for making seniors more

insignificant zeke. Go sell it to the right wingers and I'm sure your bro rahm will appreciate it too.

Give Me A Gigantic Fucking Break!!!!!

[treestar]

41. Being described as a "trained oncologist"

does that mean he never actually practiced it?

[TBF]

42. I would hope he would

never get close to actual patients. Can you picture it? Nope, you're 76 - no meds for you. It's time for you to die.