‘Die at 75’ advocate’s political motives hidden

By Jerome R. Corsi

Dr. Ezekiel Emanuel
Dr. Ezekiel Emanuel

NEW YORK – Missing in The Atlantic magazine’s recent presentation of Dr. Ezekiel Emanuel’s column declaring his desire to die at age 75 is the fact that he is a chief architect of Obamacare, with a vested interest in curbing life expectancy in a system of limited resources that forces moral decisions concerning who will receive health care and who will not.

In the column, Emanuel argues that improvements in health care that extend life expectancies through vaccines, antibiotics and technological innovations end up “stretching out old age,” resulting in “a progressive erosion of physical functioning.”

While Emanuel emphasizes the personal benefits of forgoing measures that extend life, the unspoken issue is the scarcity of resources in a system beholden to a fixed government budget.

If older people don’t follow his chosen course and willingly allow resources to be distributed more to the younger, productive workers in society, government bureaucrats will inevitably enter into those health-care decisions.

A longtime advocate of health-care rationing, Emanuel helped craft Obamacare as health-policy adviser at the White House’s Office of Management and Budget. He’s identified at the end of The Atlantic article as director of the Clinical Bioethics Department at the U.S. National Institutes of Health and head of the Department of Medical Ethics & Health Policy at the University of Pennsylvania.

In a Wall Street Journal column in 2009, as Obamacare was being conceived, Betsy McCaughey, chairman of the Committee to Reduce Infection Deaths and a former lieutenant governor of New York state, noted Emanuel was “part of a school of thought that redefines a physician’s duty, insisting that it includes working for the greater good of society instead of focusing only on a patient’s needs.”

McCaughey pointed out that in numerous writings, Emanuel chastised physicians for thinking only about their own patients’ needs.

She cited Emanuel’s piece in the June 18, 2008, issue of JAMA in which he blamed the Hippocratic Oath and its admonition to “use my power to help the sick to the best of my ability and judgment” for the “overuse” of medical care.

In the medical journal The Lancet, Jan. 31, 2009, Emanuel and co-authors presented a “complete lives system” for the allocation of very scarce resources, such as kidneys, vaccines and dialysis machines.

They contended it was “unclear” whether or not it’s best to “save one 20-year-old, who might live another 60 years, if saved, or three 70-year-olds, who could only live for another 10 years each.”

But McCaughey argued Emanuel and his colleagues articulated a clear choice.

He and the authors wrote that their “complete lives system produces a priority curve on which individuals aged roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get changes that are attenuated.”

‘Death panels’

Critics of Obamacare would argue that the alternative to Emanuel’s call for older people voluntarily to forgo costly medical care would be a government body that makes those decisions for the patient.

When former Republican vice-presidential candidate and Alaska Gov. Sarah Palin warned that under Obamacare, the elderly and infirm would be forced to stand before “death panels,” she was widely ridiculed.

Since then, however, many promoters of Obamacare, including Howard Dean – the former head of the Democratic Party and a former medical doctor – have admitted the law’s Independent Payment Advisory Board is a “health-care rationing body” with the authority to “stop certain treatments.”

On her Facebook page in 2009, Palin wrote that Obamacare would have a “coercive effect” on patients because its advisory panels are part of a law that aims to reduce the growth in health-care spending.

Palin said:

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

‘Living too long is a loss’

In his column, Emanuel says he has actively opposed legalizing euthanasia and assisted suicide, but he argues people should refuse measures that prolong life, not only to reduce society’s burden but to benefit oneself.

“Living too long is a loss,” Emanuel argues. “It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nevertheless deprived.”

Emanuel concludes that by the time he reaches 75, he will have lived “a complete life” in which he envisions having seen his children grow up, his grandchildren born and his life projects basically completed.

“Dying at 75 will not be a tragedy,” he writes. “Indeed, I plan to have my memorial service before I die. And I don’t want any crying or wailing, but a warm gathering filled with fun reminiscences, stories of my awkwardness, and celebrations of a good life.”

Emanuel paints a dismal picture of the elderly, writing: “Even if we aren’t demented, our mental functioning deteriorates as we grow older. Age-associated declines in mental-processing speed, working and long-term memory, and problem-solving are well established. Conversely, distractibility increases. We cannot focus and stay with a project as well as we could when we were young. As we move slower with age, we also think slower.”

By age 75, Emanuel figures that “creativity, originality, and productivity are pretty much gone for the vast, vast majority of us.”

He produced the following chart to make his point:

productivity

Emanuel paints a picture of how he plans to reduce society’s burden for taking care of him as he approaches age 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. (When a urologist gave me a PSA test even after I said I wasn’t interested and called me with the results, I hung up before he could tell me. He ordered the test for himself, I told him, not for me.)

He says that if he is diagnosed with cancer after age 75, he 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.

He ends the piece by insisting he is not trying to convince anyone else but only express his own wish to die gracefully by age 75.

Yet skeptics will point out that Emanuel, born in 1957, has not yet reached 60. And just as his thinking about life no doubt has changed since his teen years, he may have a different view of 75 when he reaches 70.

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