In “Why I Hope to Die at 75” from last October’s issue of the Atlantic, Ezekiel Emanuel attempts to counter the prevailing cultural aversion to death with little more than rhetorical shock. Veritably a major voice in healthcare policy in the United States, he has proved enigmatic to friends and family by insisting that he wants his life to end at 75 and has vowed to accept only palliative care upon reaching that age. There’s nothing special about 75, but it’s the age that he deems probable to coincide with “a complete life” and, essentially, the termination of his dignity.
Given the tremendous lengths covered by our society to postpone or divert the inevitable, one might suppose that death and suffering are the two great enemies of the modern American. “American Immortals,” as Emanuel terms them, make up a generation of health-seekers and the industry that supplies them. The desperation for youth and immortality has formed into strict diets, pills, cure-all stem cell research initiatives, Google’s Calico venture to “solve” illness and aging, and so on. Something unhealthy is lurking beneath this quest for health.
In contrast to this quest, Emanuel believes that living too long is bad because at a certain point we will be deprived of our vitality and the goods of youth. We will break down in mind and body, and this enervation will burden our family members and overshadow their own growth. In living past our peak years of self-realization, we hamper the self-realization of our children. At some point (say, age 75) we mysteriously pass from being a blessing to being a burden.
To some extent I agree with the sentiment that Emanuel is offering. He is right to suggest that satisfaction in a long life and a selfless concern for one’s family are admirable qualities. Are there not things worse than death? To desire life at any cost is a potential perversity inherent in the excesses of the human soul. Employing art and science to find cures to disease and improve quality-of-life is indeed a good endeavor; but when these endeavors are made into an ultimate good, and at the expense of higher ones like goods of the soul, there emerges a problem.
Despite these considerations, Emanuel’s underlying reasoning is facile.
His key supporting premise is that life is not worth living unless one is able to achieve a certain level of creativity, productivity, relationships, and achievement. These goods are what make life tolerable and desirable for him. Certainly they are all valuable things, but is a certain degree, or any number, of them a requisite to keep on breathing—or inversely, to stop?
Emanuel professes his opposition to euthanasia, yet his judgment of his own life's worth undercuts this profession. If, one may wonder, self-realization of the sort outlined above is what makes life worth living, how are we to justify respecting the lives of those whose illness or disability preclude such achievement? What principle is there to suggest that they too have an inviolable right to their own lives? One cannot mount a defense of the importance of human beings and their rights from the mistaken vantage that all that is special about them is what they can do. To think otherwise is to indulge a specious capitulation of reason to sheer will, which is exactly what Emanuel does here. Besides this foundational incoherency, his cowering from objective argument (e.g. “I’m not even trying to convince anyone I’m right”) only compounds the futility of his view.
He goes on to document some of the realities for seniors who live beyond the threshold of previous generations. Senility, dementia, Alzheimer’s, immobility, and other physical ailments are highlighted to illustrate the insatiability of this condition. Naturally no one desires these sufferings. But how is this not the same reasoning at work behind the tragic assisted suicide of Brittany Maynard this past November? The only difference is that the end of her dignity and self-realization was more imminent than some imprecise point in the future. She could find no reason to endure the suffering of her disease, no silver linings, no virtue; pain, suffering, and death are simply and fundamentally evil, and there’s no redemption to be had in them.
This is a philosophy of hopelessness at work. The truth is that suffering is unavoidable, and those who heroically endure it are in a tangible sense purified: which is to say, they are spiritually purified. They need no longer be controlled by ignorance, illicit attachment, pride, and presumption; and their family and loved ones have the opportunity to unite to witness the true magnificence of strength in the face of struggle, virtue in the face of temptation, and fidelity in the face of finality. The sufferer teaches others how to suffer well; that is, to live well.
The only alternative to Emanuel’s indigent view of the end to human life, the burdensome senescence that awaits anyone who lives beyond his productive years, is to recognize that life itself is a gift. If our lives are a meaningless few decades of self-seeking realization and consumption, and a few mere moments when we seem to have everything that we desire is the best it gets, then there’s no point in growing old. In fact, there’s no point in enduring loss or hardship at all; if one is irreconcilably a sufferer sans redemption, why carry along?
But our condition is not as dire as that. We are not made for this world, though we are tested in it. We are given everything that we have, most primarily our lives; as stewards we are born, and as stewards we will die. The truth is that the purification that comes from suffering is a providential opportunity to align ourselves with the truly important things, most essentially God. Emanuel recognizes the obvious goods of creativity, friendship, and the ripe meaningfulness of the appealing parts of life, but fails to recognize the equal profundity of the difficult ones.
His is the overwhelming view of death and suffering in our time. In adopting this view, Emanuel only reinforces the logic behind offenses against human dignity like euthanasia, abortion, and inured penury. Any truly radical break with the common sense of our age would counter the attitude of meaninglessness in dying with a defense of human worth that recognizes the importance of a good life and a good death.