This paper analyzes the quality versus quantity of longevity of life in accordance with society and bioethics. This is followed through by the analysis of Dr. Emmanuel’s “Why I Hope to Die at 75” article and a rebuttal to it from “Bioethics and Why I Hope to Live Beyond Age 75 Attaining Wisdom!” by Miguel Faria. Dr. Emanuel discusses the destructive notion of the “American Immortal” by how it imposes in supportive cost on society and how old age deprives us of living. Conversely, Miguel Faria discusses how the ideology of the “duty to die” rejects the belief of “first do no harm” while claiming the “good life” is when we age and have the time to reflect on our life. The goal is to identify which argument is logical and what policy must be done by it to balance the dilemma of technology, morality, and the cost of extended care, coupled with a reasonable healthcare system for this.
Analysis of Dr. Emmanuel’s 75 age limit In the article, “Why I Hope to Die at 75”, by Dr. Emmanuel, the argument here is that as we grow older we enter our lesser quality years and we are not immortal to death, therefore bioethics medical care should be limited to our more productive individuals. Dr. Emmanuel states “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” (Emmanuel,). In other words, old age prevents us from living life. It prevents us from contributing to our society and world while altering how people experience us. Although he strongly opposes legalized euthanasia and assisted suicide, Dr. Emmanuel believes we should let nature take its course once we reach this old age instead of trying to prolong life, such as flu and pneumonia shots, vaccines, antibiotics, and other medical care. As a result, stretching out the lives of the elderly is depriving us of saving younger people because the efforts that go into living longer include extreme lifesaving medical interventions.
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This “American immortal” perception only imposes an insupportable cost on society in their quest to extend their lives. Caring for the elderly is a financial burden and this consumption is not worth their contribution. To put it differently, our elders should step aside for the rising generation to free up society’s resources to support our children and allow younger workers to thrive. This includes the cost of the programs for retirees such as Medicare and social security, which is a drain on the federal government. Consequently, this spends less on the needs of the children. Due to our nature of struggling to survive, we tend to reject the belief of our “duty to die”, giving no acknowledgment to why we are here. We are already programmed to be in a routine of survival, but is it worth it at a certain age? Analysis of “Bioethics and Why I Hope to Live Beyond Age 75 Attaining Wisdom!: A Rebuttal to Dr. Ezekiel Emanuel's 75 Age Limit” In the article “Bioethics and Why I Hope to Live Beyond Age 75 Attaining Wisdom!” by Miguel Faria alternatively the argument here is that longevity of life should be kept and that bioethics is worth this. American bioethicists argue the need to conserve medical care for limited healthcare resources. The use of government-imposed euthanasia, not only for the terminally ill but for the unproductive elderly can prevent bankruptcy for medical care. The bioethics movement revolves around the ideology of “the duty to die” while rejecting the belief of “first do no harm”. The movement is based on the population and is concerned with the conservation of resources.
This ignores the best interest of the induvial and the worth of human life. The author argues that we do not lose our creativity as we age, we just become more of an advisor with responsibilities that withhold us from creative activities. Coupled with this, though it becomes more difficult to learn as we age, we still can do it if we remain active. In a study done at the University of British Columbia, researchers found that regular aerobic exercise, the kind that gets your heart and your sweat glands pumping, appears to boost the size of the hippocampus, the brain area involved in verbal memory and learning (Godman, 2014). Furthermore, it is not feasible to confirm that the “good life” is our productive years but more so when we have the time to reflect on our lives, which happens once we have aged due to our rapidly demanding society. Moreover, there is time for fulfillment in improving society in creating a better world for our children and grandchildren. Life Is Worth Living Beyond 75 If You Adjust Your Mindset! Although I understand the many challenges faced with living beyond 75 as described by Dr. Emanuel, I do not think they are as bad as he plays them out to be. If he would look more closely into the beauty of aging instead of dreading it, he would find that along with those negatives, there are just as many positives to look forward to. Dr. Emanuel is only stuck on the physical limitations of aging such as walking, climbing stairs, standing without special equipment, or sitting for too long. He fails to look at the other picture, as we age, we are better able to appreciate life and the wisdom we have gained from it over the years. Although, Dr. Emanuel realizes the importance of mentorship, a vital role the elderly has, he devalues it as a “constriction of our ambitions and expectations”.
I believe as we age our professional ambitions involve new selfless ones. Mentoring younger colleagues are just as important as being physically productive at work. The elderly are experts at what is important from the past to carry on to the future. Moreover, Dr. Emanuel believes we become mentally deprived with age, associating it with an increase in dementia. Old age is not a cause of Alzheimer’s, scientist believe that for most people, this disease is caused by a combination of genetics, lifestyle, and environmental factors that affect the brain over time ('Alzheimer's disease', 2018). We don’t have to accept the fact this is an inevitable part of aging if we simply modify our lifestyle to prevent it, such as exercising regularly, having a healthy diet, and constantly engaging our brains in learning. For example, after spending his youth as the leader of the African National Congress’s armed wing and being imprisoned for 27 years, Nelson Mandela was able to bring about unity in his 70s as an anti-Apartheid activist. Character development is something that happens to all of us as well by dealing with unexpected changes in life and from this, we mature over time. Aside from that, one thing I do agree with Dr. Emanuel on is not trading quality of life for quantity. I see why he questions the assumptions of the “American immortals” and their “maniac depression to endlessly extend life” because the notion that additional years are always better can lead to destructive expectations. Medical care, at any age, can be a trade-off between longer life and better life and it’s reasonable to question when it is appropriate to make that trade and when it is not.
I personally believe that a decision is an individual one that depends on the person’s goals. Incorporating empathetic end-of-life counseling into medical care could greatly improve our quality of life, and age should not be the only factor going into this. I don’t want to come off as an overly optimistic person because I do consider myself more of a realistic person, but I do not believe aging is as bad as people think. Each stage of life has a meaning that’s possibly to be satisfying depending on your mindset. Policy Alternative I believe the healthcare needs of older adults coping with multiple chronic conditions, which account for the majority of Medicare expenditures, are just poorly managed. Management that collaboratively engages the older patient, their family caregivers, and clinicians in identifying the patient’s needs and goals to implement that individual care plan would achieve better healthcare. As I stated earlier, it is all about the mindset of the patient and once that is identified determination of enrolling in Medicare part B can or can not be an option for the patient. Moreover, this will avoid under or over-treatment of the patient to save money on healthcare spending overall. Many elderlies buy into the fact that they are no longer useful and make little attempt to keep themselves alive and active, but then there are some older people who continue to learn and be actively involved in business or the community. The best healthcare system that could help in distinguishing this would be Taiwan’s “National Health Insurance” model. This program is like the U.S. Medicare one, yet they have the lowest administrative costs in the world thanks to technology and the country’s single insurer.
Every citizen has a smart card, which is used to store his or her medical history and bill the national insurer. This helps public health officials monitor standards to affect policy changes nationwide. This gives the government a “real-time picture” of the patient’s health patterns. This way there can be an understanding of this person’s lifestyle and goals when it comes to their health. I believe we do not have a “duty to die”, but we do have a “duty to stay alive”. If a person, regardless of age, does not want to support a duty to live, then that is no one else’s responsibility either. Conclusion In conclusion aging is inevitable but becoming old is not. Society has associated old age with being weak, fragile, and non-productive mentally and physically, making it a burden on society financially. Unfortunately, this notion has convinced many elderlies that this is a part of life and it is only right to let nature take its course, as Dr. Emanuel believes. However, these traits do not come from old age, but old age comes from these. As quoted by the great Muhammad Ali, “Age is whatever you think it is. You are as old as you think you are”. The concept of, it is your duty to die to make way for the younger generation, which Dr. Emanuel ejects out is a depressive abstraction to associate with aging. The elderly offers society something the younger generation cannot, and that is mentorship expertise. Medical care at any age is a swap between longer life and better life, and with the help of end-of-life counseling, a collaboration of engagement of the patient, family caregiver, and provider, along with Taiwan’s healthcare system we can determine when to make that swap and when not to instead of solely following the assumption of a “duty to die” once we age.
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