Do you want to live beyond age 75?
Ezekiel Emanuel hopes to die at age 75. At least that's the title of a controversial article he recently wrote for the Atlantic. Emanuel, the 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, has obviously given this a lot of thought.
If you read beyond the attention-getting headline, however, Emanuel is clear that he's not going to commit suicide at age 75. Rather, he'll just stop accepting life-extending interventions such as flu shots, preventative tests, chemotherapy and surgeries. In this case, it's a pretty safe bet he'll keep living well beyond age 75, when the odds of dying are roughly one in 25.
His rationale for discontinuing life-extending measures? By age 75, Emanuel says he'll have lived a complete life. For instance, he'll have seen his children launched into the world and grandchildren born. He's concerned about the physical limitations that are inevitable as you age, including a loss of creativity and the ability to work and contribute to your family, society and the world.
Emanuel rejects what he calls Americans' obsession with life extension by exercising, following strict diets, doing mental puzzles and popping supplements and other concoctions. He thinks our society isn't so much extending life as extending the dying process -- lengthening the time you're a victim of a debilitating chronic illness or the fragility of old age.
He wants to die before he becomes a burden on his family and society. He wants to be remembered as vital and healthy, not feeble and pathetic.
These are good good points and worth thinking about, but I disagree with Emanuel's basic conclusion -- that individuals, families and societies are better off if we die "swiftly and promptly," as his article's subtitle puts it.
I plan to live a long, healthy life that extends well beyond age 75 and includes continued contributions to my family and society. So, I'm taking steps to increase the odds that I'll be vital and healthy as long as possible. And I've made financial plans so I won't be a burden on my family if I need medical or long-term care. That's the responsible thing to do.
I'm not obsessed with popping pills and strict diets. Instead, I savor the food I eat, have fun getting my exercise and enjoy the way I look and feel.
How many people are over the hill by age 75? According to a recent study by researchers at RAND, the University of Illinois, Stanford University, and the University of Southern California, 33 percent of people aged 75 to 79 reported their health as "very good" or "excellent." It's probably safe to say this group is glad they're alive!
But "very good" or "excellent" is a pretty high bar. For many people, it's possible to have some health issues and still be able to work, contribute to your family or community, not be a burden on others and enjoy life.
By this measure, the researchers found more than three-fourths -- 77 percent -- of those age 75 to 79 reported no limitations in their ability to work or do housework. Most likely this group isn't much of a burden on anybody.
Only 12 percent reported needing some help with daily living activities or instrumental activities of daily living. This is the group that could possibly be considered a "burden" to others, although the actual proportion is likely to be much lower.
In a recent interview on CBS News, medical contributor Dr. David Agus rejects the idea of an arbitrary age beyond which you're no longer vital. Agus is optimistic about developing science and research that will help us live a long, high-quality life, with the potential to arrest or reverse some of the existing deadly diseases of old age.
Emanuel seems obsessed with how others will remember him and how they'll view him in his old age. "I want to celebrate my life while I'm still in my prime," he says. But is that really a good reason to stop living?
My parents and other older relatives still had a lot to contribute to their family and friends well after their prime years. At age 91, my mother inspired our entire family by attending the wedding of her granddaughter, a year before mom passed away. She enjoyed herself and looked jubilant.
My father hobbled to the high school graduation of another granddaughter -- my daughter -- a year before he died at age 88, inspiring us with an example of perseverance and family support.
While both are gone now, our family reveres the memory of the entire arc of their lives, from vitality to old age. Both needed care in their final years, and it was our honor to shoulder the burden by helping with their transition. The grandchildren saw their parents take care of the grandparents with love and devotion -- a great life lesson for younger generations.
Emanuel does raise serious issues that deserve discussion and debate. Boomers are on track to become a significant burden on the next generation in our later years, given our poor eating, exercising and spending habits. To mitigate this looming disaster, Agus reinforces the need to improve our health habits, and I've long advocated that people take the time to properly plan for their retirement years.
Many may also need to work in their retirement years to make ends meet, but so far, employers don't appear to be lining up to hire older workers en masse, and the average age at retirement hasn't increased in recent years. It's pretty clear that individuals, communities and society will need to evolve to accommodate an aging population, but it's definitely doable if we find the will.
So, does Emanuel, who's currently 57, really want to die at 75? Or is his real goal to stir up controversy and debate, from a safe distance of 18 years away, on how we can best live more consciously in our later years so we continue to contribute to society and not be a burden?
At the very end of the article, Emanuel reserves the right to change his mind as the time approaches. It will be interesting to check in with him in 2032 -- and I plan to be alive to do just that.
What's your opinion? Do you want to live beyond age 75?
