On this episode of Lifespan News, Ryan O’Shea talks about a real-world doctor whose euthanasia-related statements parallel those found in science fiction.
Script
When do you want to die? Or, phrased differently, when should humans die? These are loaded questions, but that doesn’t keep them from being answered all the time, with some alarming implications for you.
In an episode of Star Trek: The Next Generation, Lwaxana met and fell in love with with Dr. Timicin, a visiting Kaelon scientist. Unfortunately, the timing wasn’t great. Timicin was soon to participate in a ritual suicide, called the Resolution, that all members of his society are subjected to when they reach the age of 60.
But this is fiction, and certainly nothing like this would take place in reality, right? Well, a number of people, including a prominent bioethicist and doctor, are making some slightly different arguments based on the same troubling logic.
The bioethicist and doctor I’m referencing is Dr. Ezekiel Emanuel, who has written a provocative essay in The Atlantic titled “Why I Hope to Die at 75.” Now, that’s a bit of a sensationalistic title that Dr. Emanuel has pushed back against (even The Atlantic needs that clickbait), but the article does detail that Dr. Emanuel has chosen the age of 75 as the seemingly arbitrary point at which he will reject medical interventions intended to prolong his life.
Here’s how CNN described it:
In the October 2014 Atlantic article ‘Why I Hope to Die at 75’, Dr. Ezekiel Emanuel vowed that when he hit that age, his approach to his health care will completely change. That while he won’t actively end his life, he wouldn’t try to prolong it. Dr. Emanuel, there are a lot of interventions, I’m going to put them on the screen, that you say, when you hit 75, you’re no longer interested in. Uh, regular preventive tests, screenings, interventions. colonoscopies and other cancer screening tests, cardiac stress test, pacemaker, implantable defibrillator, heart valve replacement or bypass surgery, flu shots or antibiotics, ventilators, dialysis, surgery, medication. God forbid if you get cancer, you’re just going to let it ride?
“Yes, sir.”
In a video from The Atlantic, Dr. Emanuel further explained his position to Dr. James Hamblin:
I don’t actually want to kill myself at 75. I don’t actually believe in legalizing euthanasia or assisted suicide.
Welp, strongly disagree with you there.
“So this isn’t about how to, you know, take your life. It’s about how to live your life. The point of the article is to look at what happens when you become physically disabled, the sort of inevitable slowing down of our mental powers, the rise, substantial rise of dementia as we get older, the loss of creativity.
We shouldn’t try to live longer. We should, you know, stop going to the doctor, stop taking medicines and treatments and interventions where the reason for them is it’ll make you live longer. I mean, I’ve told my kids that You know, if God forbid I have a lurking aneurysm in my head and it bursts, don’t scream a lot of big tears for me. I’ve had a fantastic life. I don’t want them to have memories of me as sort of frail, forgetful, constantly saying, what did you say? What did you say?”
So, there is Dr. Emanuel’s position. He thinks it’s a good idea to stop medical interventions to prolong life at the age of 75, because he doesn’t want to extend a life that is statistically likely to experience diminished function and performance, and he doesn’t want to become a burden to his family, or for them to remember him as a frail, failing human. Now let’s see just how similar this sounds for the reasons Dr. Timicin gives for the Resolution in the Star Trek universe.
Fifteen to twenty centuries ago, we had no resolution. We had no such concern for our elders. As people aged, they… their health failed. They became invalids. And those whose families could no longer care for them were put away into Death Watch facilities, where they waited in loneliness for the end to come sometimes for years. They had meant something. And they were forced to live beyond that into a time of meaning nothing. Of knowing that they could now only be the beneficiaries of of younger people’s patience. We are no longer that cruel, Lwaxana. No, no, you’re not cruel to them, you just kill them. The resolution is a celebration of life.
It allows us to end our lives with dignity. Ah, a celebration of life. Sounds very noble, very caring. What you’re really saying is you got rid of the problem by getting rid of the people. It may sound that way, but it… It is a time of transition. One generation passing on the responsibilities of life to the next.”
So the obvious question here is, how does anyone settle on some arbitrary age at which it’s not worth prolonging human life? Well, here too, the answers from Dr. Timicin and Dr. Emanuel sound quite similar.
“If I could convince you to push it back to 77 even. Yeah, no. 76? No. September 7th, you know, 2032. That’s it.”
“Why 60? Why not 62, 58? A reasonable age had to be set. But it’s not reasonable. Certainly not in your case. You’re as vital and healthy a man as I’ve ever known. That is why I wish to say goodbye to my family and colleagues while I am this way. In full command of my faculties. Knowing that they will always remember me as a strong and vigorous man.
But it makes no sense. Some of your people could still be active at 70 or 80, and others might be seriously ill at 50. How cruel of you to make them wait so long to commit suicide. Setting a standard age for the resolution makes it uniform for everybody to ask individual families to decide when their elders are to die.
That would be heartless. I agree.”
Lwaxana is right. That would absolutely be heartless. But here’s the thing – Dr. Timicin and Dr. Emanuel aren’t necessarily wrong, they are just extreme. It is awful that people today face the question of when additional medical intervention should be withheld from themselves and their loved ones, but it happens all the time. For many people, there comes a point at which the pain, stress, costs, resources, and diminishing returns of attempting to keep someone alive makes continuing undesirable.
We can’t say that occurs at 60, or 75, but it does occur.
But that’s today. That logic is based on the current state of science, technology, and medical understanding. But it doesn’t make sense in a world in which rejuvenation biotechnologies are available, when someone who is 75 or beyond can maintain their physical abilities and mental acuity. In that situation, it makes complete sense to provide medical interventions to everyone, regardless of age – because there is hope that whatever they are facing could be truly overcome. We’re extending healthspan, not just lifespan, and that’s what people care about.
And I think Dr. Emanuel would come around to this. He’s not scared of being 75, he’s scared of being frail and unhealthy, as we all are. If we’re able to convince him that this future is possible in his lifetime, I’m confident his mind will be changed. He even basically said so when Dr. Hamblin was humorously trying to convince him to change his mind by explaining that he would miss the things that make life worthwhile, such as cats and trips to Indiana.
“You have to be more persuasive. Yeah. What can we do to be more persuasive? Cure Alzheimer’s, that would be a really big thing. That might, that might truly make me rethink. That would be amazing. It would be amazing.”
Dr. Emanuel turns 75 on September 7, 2032. I think it should be our goal to make sure that he doesn’t die having given up hope on the possibility of a happy and healthy future.
And if that doesn’t work, I agree with Lwaxana:
“Well, if that’s the way it is, I don’t know why anyone’s bothering to try to save your planet at all. If it’s time has come, let it die. Where’s the difference, Timicin? Where?”
To learn more about Dr. Emanuel’s controversial article, and equally controversial appointment to then President-elect Joe Biden’s COVID-19 Advisory Board, check out Steve Hill’s Lifespan.io article “Why I Hope to Be Alive at 75”, linked here and in the video description.
So, do we have a shot of changing Dr. Emanuel’s mind? Did Timicin’s Kaelon culture have a point? Let us know your thoughts in the comments. Also, there’s much more to say about these topics, and I think my earlier thought about being in favor of legal physician-assisted suicide, especially in a world of indefinite life extension, could warrant it’s own episode if there’s interest in that. But for now, please subscribe so you don’t miss out. I’m Ryan O’Shea, and we’ll see you next time on Lifespan News!