Ezekiel Emanuel did the Evening Keynote presentation at the Marcus Evans CXO Post Acute Summit . . . his presentation was intriguing, to say the least.

By Steve Moran

There is this guy by the name of Ezekiel Emanuel who did the Evening Keynote presentation at the Marcus Evans CXO Post Acute Summit in West Palm Beach, Florida, the second week of July. It had to be one of the most fascinating and weirdest (given the context) presentations I have ever experienced.  

He spent some time talking about his futurist (my term) view of the healthcare delivery system, that is intriguing and, if right, will have some profound impacts on the healthcare system.

The Weird Part

Back in 2014 The Atlantic published an article he authored titled Why I Hope to Die at 75. In 2016 this is still his proposition and he talked about why he says he wants to die at 75. Before I get to the why part there were two things that were just weird about the whole thing:

  1. At a Post Acute Care Conference? — It seems seriously weird to have a guy who wants to die, or more accurately, accelerate the dying process when he turns 75 (more about his thinking below) at a conference where the participants are 99.5% dependent on people he thinks have little or no serious quality of life . . . and presumably value to society.

  2. It is Easy to Say Now — When he opened it up for questions I had to ask: “How old are you?” His answer 58 and a few months. If I could find someone to take a bet, I predict . . . if he is honest with himself that when his 75th birthday rolls around . . . assuming he is still in good health, he will not feel the same way.

His Thinking

You can read his thinking in excruciating detail in the article linked above but here are the highlights:

  • Fundamentally he acknowledges death is a loss, and he argues, that at some point living too long is also a loss. While I guess I would agree with that at some level I am not sure 75 is it. I am pretty sure my 80-something parents would not be on board with this.

  • He argues that for all but a tiny, tiny percentage . . . perhaps less than 1% have the ability to create, work or contribute to society.  

  • He seems to be arguing that we should get on with the business of dying to conserve resources for those coming behind us.

  • Further he argues that sometime after 75 we are not seen as or remembered as anything but feeble, ineffectual. He caps his argument off with the proposition that we are even seen as “pathetic.”

Clarity

He is not arguing for assisted suicide or euthanasia. In fact he claims to be staunchly opposed to these things. Rather, he says, his plan is to stop doing anything to increase his lifespan. He will stop taking drugs that will extend his life. If he gets cancer he will opt to refuse treatment. If he has high blood pressure, he will refuse or quit taking medication to counteract the high blood pressure.  

Completely Misses the Point

We are living longer, way longer. An increase in longevity of close to 20 years longer than 1980. Mostly we are living healthier. Many jobs are less taxing on the body and, in spite of our current terrible eating habits, our diets are better. We have better medicine. We have more and more seniors doing amazing things at advanced ages. 

In my view this is the ultimate in defeatist, even bigoted ageism. However, I am still betting he will have a serious change of heart when he hits 75 and is creating and working and contributing.

Just take a look at the photo to the right — cropped from the cover image above. This is my 87 year old dad who went white water rafting with us 2 weeks ago. You can clearly see my dad is having a blast and enjoying the experience just as much as the rest of us . . . if not more so! He is obviously still living a vibrant life and making the world a better place.

Yet, Emmanuel would just as soon he be dead.

The Very Worst Parts

Promulgating an idea like this has two terrible consequence:

  1. It allows medical professionals to be cavalier about treating older patients. I have seen it with my mother. They just didn’t pay attention to her total needs as they would have for a child or a teen or even a young or middle-aged adult.

  2. It makes it much harder to have real serious meaningful discussions about end of life issues for elders. When someone smart, influential, and prominent says, there is really no point in living . . . in prolonging life after age 75, what kind of discussion can you possibly have with someone facing serious end of live choices at 80 or 85 or 90?

No thanks. I believe old life is valuable.

Marcus Evans holds three post-acute events per year in various parts of the country.  
You must be a decision maker in an organization that has at least 500 residents to get an invitation. For more information you can go here:  
http://events.marcusevans-events.com/long-term-care-summit/