Ezekiel J. Emanuel makes a compelling argument. Please read it all here! Here are some salient excerpts:
Rather than saving more young people, we are stretching out old age.I am 75. I have reached Emanuel's goal line. Touchdown! But now I am entering the endzone. Does that mean I'm celebrating? I don't know. But this week I have purchased the only item which was ever on my bucket list. And it's been on that short, short list a very long time. Expensive. A stretch. Definitely out of my comfort zone. But there it is...
. . . .over the past 50 years, health care hasn’t slowed the aging process so much as it has slowed the dying process.
. . . .a key issue with aging: the constricting of our ambitions and expectations.
. . . . My view does have important practical implications. One is personal and two involve policy.
Once I have lived to 75, my approach to my health care will completely change. I won’t actively end my life. But I won’t try to prolong it, either. Today, when the doctor recommends a test or treatment, especially one that will extend our lives, it becomes incumbent upon us to give a good reason why we don’t want it. The momentum of medicine and family means we will almost invariably get it.
My attitude flips this default on its head. I take guidance from what Sir William Osler wrote in his classic turn-of-the-century medical textbook, The Principles and Practice of Medicine: “Pneumonia may well be called the friend of the aged. Taken off by it in an acute, short, not often painful illness, the old man escapes those ‘cold gradations of decay’ so distressing to himself and to his friends.”
My Osler-inspired philosophy is this: At 75 and beyond, I will need a good reason to even visit the doctor and take any medical test or treatment, no matter how routine and painless. And that good reason is not “It will prolong your life.” 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.
