We live longer and longer. So far so familiar. In any case, from a Western perspective, this is basically synonymous with: This is an enormous step forward in civilization. We are getting older – and we will be able to enjoy the gain in lifetime healthy and fit. Healthcare in old age ensures that we extend the phase of active life. It promises to limit and limit the time of helpless, suffering existence.
The counter thesis represents Ezekiel J. Emanuel, oncologist and medical ethicist at the University of Pennsylvania. He’s pointing: We’ll postpone the date of our death. The time, however, when we can no longer live fit and active, is moving forward. And drastically. His consequence: He plans to limit his life. 75 is a good age to be remembered positively by family and friends. To be precise, Emanuel is not planning suicide or euthanasia. But after his 75th birthday he will only accept palliative medicine, not curative medicine. No tests for prevention, no nutritional optimization, no exercises for mental fitness. Healthcare in old age exclusively for the well-being, not for the prolongation of life.
He published his position and the underlying statistics in a detailed article in The Atlantic: Why I hope to die at 75. The editor Mareike Kürschner took up a conversation again and now, four years after the statement, asked again (Paywall). Meanwhile Emanuel is 61 years old – the self-chosen end is in sight. We’re in position.
The path to self-determination
Two thoughts stand out: Emanuel describes quite touchingly how the fact of the self-chosen end completely changes his perspective on the years before. How he feels activated to take care of the big questions of life. To attract important people from his environment, to learn, experience, experience… Obviously, the limitation of life expectancy leads to exactly the degree of self-determination and self-efficacy that healthcare providers often promise in vain in old age.
The second idea lies on a higher level: We afford to spend a considerable portion of the health care costs for the last 14 days of life alone. Against this background, the conscious renunciation of the attempt of healthcare in old age to find out a few more months of life is almost revolutionary. As understandable as this attempt may be in individual cases – from an overarching perspective it sometimes seems somewhat desperate.
I put this up for discussion: the better we understand how to prolong human life, the greater our responsibility grows to determine the point in time at which the bow closes with dignity. tbc.