Tuesday, September 23, 2014

Dispatches From The Culture Of Death Part One: Should We Give Up At 75?

The Culture of Death     

There are those who say that St. John Paul II was exaggerating, or at least being unduly harsh, when he coined the term “Culture of Death” in his encyclical Evangelium Vitae.  If only that were the case. The secular world simply insists on offering death as the “compassionate” response to all sorts of things: suffering at the end of life, difficulties at life’s beginning and, increasingly, trouble in between.  Today I’d like to explore one recent example of the Culture of Death at work, and a second tomorrow.

The Architect of Obamacare

     Let us consider  Ezekiel Emmanuel, brother of President Obama’s former Chief of Staff Rahm Emmanuel.  Ezekiel, one of the prime architects of the monstrous Affordable Care Act (a.k.a. Obamacare), published a piece in The Atlantic last week called “Why I Hope To Die At 75” [here].  The wide-ranging essay explores at great length the disadvantages of old age: reduced productivity, lessened vitality, the host of physical ailments that proliferate as we age, but, interestingly, doesn’t focus on the effect of these things upon ourselves:

Doubtless, death is a loss . . . But here is a simple truth that many of us seem to resist: living too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.[my italics]

It is selfish of us, you see, to force others to experience our decline: the compassionate thing is to quit while we are ahead.  Emmanuel is most emphatic that he is not advocating euthanasia or physician-assisted suicide, quite correctly pointing out that “the answer” to the desire to actively bring about one’s own death “is not ending a life but getting help. I have long argued that we should focus on giving all terminally ill people a good, compassionate death—not euthanasia or assisted suicide for a tiny minority.”

Just One Man's Opinion?

     So what is he advocating? He claims that he will refuse any “life-prolonging” treatment of any sort: “I will stop getting any regular preventive tests, screenings or interventions.  I will accept only palliative – not curative – treatments if I am suffering pain or other disability.”   After a lengthy recitation of the routine treatment he intends to forgo, Emmanuel says “I will die when whatever comes first takes me.”
     We could just dismiss this as no more than one opinionated man’s personal view, and Emmanuel encourages us to do just that:

I am not saying that those who want to live as long as possible are unethical or wrong. I am certainly not scorning or dismissing people who want to live on despite their physical and mental limitations. I’m not even trying to convince anyone I’m right. . . And I am not advocating 75 as the official statistic of a complete, good life in order to save resources, ration health care, or address public-policy issues arising from the increases in life expectancy.

But he gives the game away when he adds:

What I am trying to do is delineate my views for a good life and make my friends and others think about how they want to live as they grow older. I want them to think of an alternative to succumbing to that slow constriction of activities and aspirations imperceptibly imposed by aging. Are we to embrace the “American immortal” or my “75 and no more” view? [my italics]

There Are Opinions, And Then There Are Opinions

And what is the point of thinking of alternative ways to live if not to bring about change?  In truth, underneath the welter of medical facts and figures and the personal focus, we see two very familiar arguments: the “quality of life” argument (i.e., a “diminished” life isn’t worth living) and the “appeal to compassion” (we should spare our family and society the “burden” - including the financial burden - of our  infirmity). 
Ezekiel Emmanuel

     Nonetheless, isn’t that just his opinion?  No, because when a prominent man, one with a “Dr.” in front of his name expresses his opinion, buttressed with all sorts of impressive medical sounding data, and in very engaging and (truth be told) well-crafted prose, it has an impact.  The more often such opinions come from such sources the less unthinkable such opinions become in the wider world, until they eventually become commonplace.  We have seen this strategy employed to perfection in recent years in the campaign to redefine marriage. 
     There is also the fact that, despite his disclaimers, Ezekiel Emmanuel is still has a great deal of influence on public policy: in addition to his well-known public connection with Obamacare he is the director of the Clinical Bioethics Department at the National Institutes for Health.  Add it all together and, as Ben Shapiro points out in a piece on the Breitbart site [here],

                 . . . his opinion carries weight.

Enough weight that the same day Emanuel’s piece published, a 21-member Institute of Medicine panel announced that we need to revamp our end-of-life care. “The current system is geared towards doing more, more, more, and that system by definition is not necessarily consistent with what patients want, and is also more costly,” said David M. Walker, former US comptroller general and chairman of the panel. The panel also encouraged end-of-life conversations with as many elderly folks as possible, and that costs could be slashed by thinking about aging differently.

Does that sound like anyone we know?  Perhaps its no coincidence, as Shapiro points out, that "Ezekiel Emmanuel was elected in 2004 to the Institute of Medicine". 
     Finally, while Emmanuel explicitly opposes euthanasia and suicide (and I don’t doubt his sincerity), the attitude towards aging that he is validating and encouraging will inevitably make those “options” more and more acceptable; and if the public thinks there’s nothing wrong with it, why shouldn’t the government facilitate it . . . or require it?  The slope is getting more slippery all the time.

Next: What could be funnier than abortion?