My grandmother is 94 and still mobile and only a little forgetful, but she's ready to die, not in a depressed way, but in a tired-and-wants-to-go-to-bed-at-the-end-of-a-long-day way.

Still, 75 would have been much too early for her.i

I'd say 75 seems arbitrary, but yeah, I'd rather be knocked out suddenly by a quick stroke or heart attack than linger on and on.

Be interesting to see if he reconsiders at 75 himself. You notice he left himself the option to renege on his promise in the last paragraph, right?

I can't help thinking that, if Grandma is encouraged to get on the ice floe at 75, that's more health care dollars available for the rest of us. And I worry because these trial balloons to influence our behavior start as suggestions and end as mandates, e.g., seat belt laws, smoking laws, Big Gulp bans.

Hmm. Sure puts that useless Buzz Aldrin in his place, doesn't it?

Go when you want, but don't try to creep on over here and set up Logan's Run "for my own good".

I'll ask him again when he's 74. If he's busy working on something, he may ask to put this whole death thing off a little longer. If everybody else doesn't decide he's old and in the way, I mean.

I couldn't bring myself to read the whole article. According to the Wiki link, this guy's some kind of big-time doctor and bioethicist, but the quoted paragraphs read like an op-ed in a student newspaper.

Got a .38 Special, up on the shelf,
I'll sleep when I'm dead.
If I start actin' stoopid, I'll shoot myself
Then I'll sleep when I'm dead.

Warren Zevon.

It is hard to believe that he is a doctor - making all these equations about medical expenses, outcomes, etc. - but, he seems to leave out the number one thing that makes us human - emotions.

Whether those feelings be simple compassion or love - they do drive humans in our lives.

If he doesn't want to live beyond 75 - and rob his family of his being around . . . well, I won't tell him how to live (or die) his life.

But, I think he needs to shut up and not "suggest" how other live theirs. And, even though he claims that he isn't telling others what to do - simply by his writing such a piece he is making that suggestion.

And, it won't be that much of a stretch for him (or others with his mindset) to tell the handicapped that their life isn't worth living either.

"You won't need that bionic leg soldier; it won't work as good as the one you lost in the war. So, you might as well do without." How soon before we hear something like that?

This is interesting to me because my parents are about that age and have had perfect health that is beginning to falter, at least with my father and decisions need to be made.

My parents were all for cutting costs by limiting procedures when they were younger but once they approached 70, they felt that they had too many good years left and resented Medicare cut-off dates. As a matter of fact, fearing that they would lose an opportunity for surgical coverage as they grew older and we moved towards increased governmental regulation, my mom had a flurry of operations such as knee replacements while she still could.

On the other hand, my mother told me that the meanest thing I could ever do was to keep her body alive longer than her mind. She was appalled when she saw a lady who clearly had dementia in her doctor's office being scheduled for heart surgery. Luckily my parent's minds are both in good working order.

Unfortunately my father is suffering from heart failure. 21 years ago he had a triple bypass and made a great recovery, swimming three miles per day until the last couple of years. That is the only "part" that he is having trouble with. They are trying to decide if they should try to treat him surgically or if he is just too old and limit the treatment to medication.

My parents aren't infirm yet - they even babysit my sister's kids and took care of me after surgery.

I appreciate thinking about these things rather than making blanket judgements. People shouldn't all be kept alive just because we can. On the other hand, I woukd hate to create policies that lead to gross over-generalization.

I think Robert has gotten the real gist of this piece. I will bet you anything that we start to hear more about how old people have a duty to end their lives early so that they don't needlessly suck up valuable resources. In the UK they have something called Liverpool Care Protocol (LCP) which is a nice, tidy way of saying they let the elderly starve to death. The hospital decides who would benefit from treatment and who would not. If you don't make the cut, you are "allowed" to die. It's a very effective cost saving tool and it's coming to a hospital near you as the costs of medical care continue to rise.

"I will bet you anything that we start to hear more about how old people have a duty to end their lives early so that they don't needlessly suck up valuable resources."

From which sources will we hear that? Because I want to watch out for those guys.

As to he original piece, meh. Sounds like someone had a deadline to meet.

He's pondering something and threw it up on the page, like coughing up a hairball.

And we're all supposed to look at it and discuss its consistency and texture while he's thinking about his next hairball.

The difficult I see with the idea is 75 doesn't mean anything. I have seen people in great condition must longer - my grandmother just renewed her driving license in her early 90s - to much younger - one of the guys I went to high school with is in terrible shape.

Medicare beneficiaries and voters already have distinctly different demographics. Project current demographic trends out 20 years. Do the math.

Then die, raboblanco.

The piece was overlong and flabby.

How come they don't make "famous" people say it shorter? Annoying.

He's pondering something and threw it up on the page, like coughing up a hairball.

And we're all supposed to look at it and discuss its consistency and texture while he's thinking about his next hairball.

Posted by: Gog_Magog_Carpet_Reclaimers at September 21, 2014 8:55 AM

I am going to print that out, tape it to my laptop, and reread it whenever I feel the compulsive urge to parse out what is lacking in something I've read online.

This piece was written by someone in my family: I Cannot Manage To Die

It was thoughtfully written. I'm glad it's out there, and grateful for the opening to share it here. Thank you Amy for the forum.

I'm currently approaching Ezekiel's best used by date. Which also means, since my memory still works fairly well, the young said "don't trust anyone over thirty." Know what, they are all over thirty now.

Obamacare put something in place to decide such matters for the rest of us as well. This is what the critics referred to as "death panels". See http://en.wikipedia.org/wiki/Patient-Centered_Outcomes_Research_Institute

Always remember (sarc). A private citizen investing his own time and resources to sell a better service is making a filthy profit (his income).

A public bureaucrat following the rules, spending all of his department budget each year, hiding his errors, and highlighting his successes, is dedicating his effort to a life of service. He receives only his deserved income, medical care, and pension for this sacrifice.

It is well known (sarc) that less intelligent, self-interested people are excluded from government. This leaves only near angels with the broad insight and compassion to decide what healthcare is acceptable, who gets what, and at what price.

Ezekiel Emanuel was (maybe still is) director of the Clinical Bioethics Department at the US National Institutes of Health. He wrote in The Lancet medical journal Jan 2009 [edited]:
( mises dot org/daily/3650/What-Soviet-Medicine-Teaches-Us )
=== ===
Allocation of healthcare by age is fair, unlike allocation by sex or race. Even if people aged 25 receive priority over those aged 65, everyone who is now 65 was previously 25.

It would be ageist to treat 65-year-olds differently because of stereotypes or falsehoods. It is fair to treat them differently because they have already received more life-years.
=== ===

Our Progressive government has a problem. Politicians and especially Progressives have promised healthcare to everyone, unlike the stingy Republicans. (Actually, Republicans have made almost as many promises.) Progessives like Emanuel have to prepare the public for the shortfall, the Great Dying. Although you paid into the system all your life, believing those promises, you should know that it is not ethically wise to give you much healthcare after age 65, and no problem if you are dead by 75. You had a great life, so quit your complaining.

Don't mind that Emanuel has a government pension and nice health plan without these restrictions or ethics.

By the way, ethically wise or not, there are not enough resources to keep those promises unless the workers pay another 5 percentage points of income into the system for another set of promises.

( www.politico dot com/news/stories/0412/75603.html )
Social Security Trustees: We’re going broke
04/25/12 - Politico by John C. Goodman
What the current value of the unfunded liability means:
=== ===
[edited] The latest report of the Social Security and Medicare trustees shows an unfunded liability for both programs of $63 trillion, about 4.5 times the U.S. gross domestic product GDP.

[$20.5 trillion of that is from Social Security, 42.5 trillion is from Medicare, and Medicaid is on top of that, but not the responsibility of these Trustees]

The unfunded liability is the amount we have promised in benefits, looking indefinitely into the future, minus the payroll taxes and premiums we expect to collect. It’s the amount we must have in the bank today earning [3%] interest for these entitlement programs to be fully funded.
=== ===

So, those programs would be paid for, if we collect the current Social Security and Medicare taxes, AND if we had a fund in 2012 holding $63 trillion in cash (current resources) paying us 3% interest.

4.5 times US production in 2011 was 25 times total private savings (5% overall savings rate). It would take 25 years of all US savings to pay for the Social Security + Medicare shortfall, again not countint Medicaid health subsidies for the needy.

( http://www.youtube dot com/watch?v=afuekTcSFfM )
This 90 second video highlights the upside-down priorities of Oregon's Medicaid system. Lobbying groups have used the political process to benefit special-interests.

Oregon provides Medicaid through government rules drawn up by political lobbying each year.
High priority: Stop Smoking. Low priority: Head Injury.
(sarc) But, Oregon is a bastion of anti-human, conservative thought. Other governments, state and federal, will get this right.
( http://en.wikipedia dot org/wiki/Politics_of_Oregon ).

EasyOpinions blogspot com

Wasn't he one of the main architects of obamacare?

Like others I read this as putting the idea out there to cut off all medical care by age 75. That is the only way o-care can bend the cost curve down, deny care.

Stradivarius was still making violins at 91when he died.
The world is richer for it.

My father was productive and useful, and never retired. He died a few days after becoming bedridden, and unable to do the work that he loved at the age of 81.
He told me he had been living on borrowed time, since 1942 and maybe he deserved a few extra good years after four years of hell in the South Pacific.

Setting an arbitrary deadline of when you think you should die, sounds like a paper pushing bureaucrat.

I once knew a man who liked to be 104. Up till 101, he lived a very full live, walking to his bank every day (that he owned)

Good genes, good diet, and a healthy lifestyle will take you one heck of a long way with a little luck.

Maybe Dr Emmanuel needs to find something worthwhile to do with his time, and set his deadlines a little less arbitrarily.

I found his piece to be feeble, ineffectual, even pathetic. Perhaps it's time for Ezekiel to start planning that memorial service now.

I found his piece to be feeble, ineffectual, even pathetic. Perhaps it's time for Ezekiel to start planning that memorial service now.

I took Emmanuel's remarks as talking about his personal choices, rather than pushing for anyone else to check out at 75. (Perhaps I'd see it differently if I'd read the whole article rather than just Amy's post.) Based on that, I do think it's silly to set a target number, be it 75 or anything else. However, this:

Americans seem to be obsessed with exercising, doing mental puzzles, consuming various juice and protein concoctions, sticking to strict diets, and popping vitamins and supplements, all in a valiant effort to cheat death and prolong life as long as possible. . .

I reject this aspiration.

I totally agree with. I eat what I like, as much as I like, and do the things I enjoy doing, all with absolutely no regard for how it affects my life expectancy.

I totally agree with. I eat what I like, as much as I like, and do the things I enjoy doing, all with absolutely no regard for how it affects my life expectancy.
Posted by: Rex Little at September 21, 2014 8:08 PM

My objective with my diet, and exercise, is to stay healthy enough to continue to enjoy the activities which Make my life worth living until I am within a few months of death from whatever.

I don't expect medicare to give me a couple of hip and knee replacements because I am too damn greedy to put down the fucking fork, and therefore put too much stress on my joints by carrying all that excess weight around.

Other people shouldn't be funding the consequences of my personal choices, which is most of what is wrong with socialized medicine.

I have seen too many of my relatives who live to eat, rather than eat to live.
They are addicted to carbs, as surely as an alcoholic craves booze, and half of them are diabetic already.

"How come they don't make "famous" people say it shorter? Annoying."

Because they actually pay them.

I'd push it 85, but yeah I agree 100%. (withstanding crazy medical advances) American culture has a terrible relationship with death.

In general we have a rather juvenile relationship, where are one thought is: live as long as possible no matter the physical, emotional, spiritual or economic cost.

Everyone dies. Better to go out (slightly) too soon than far too late.

Hey, do ya think Sarah Palin really knew this was their plan all along?

"Everyone dies. Better to go out (slightly) too soon than far too late."

Pray tell - who does the choosing?

Your statement is very scary. Freedom is apparently not something you prize comrade.

Pray tell - who does the choosing?

I think Andrew is telling us what he'd choose for himself, not what he'd force on anyone else. It's certainly what I'd choose.

I will bet you anything that we start to hear more about how old people have a duty to end their lives early so that they don't needlessly suck up valuable resources.

Duty implies civic virtue, I'd say they deserve it for decades of voting to fuck over the children, grand children and great grandchildren financially t fund a bunch of shit the didnt NEED but wanted to have with out having to pay for it themselves.

Why the fuck shouldnt they be the first to pay the piper when the bill comes due as they are the ones who hired the motherfucker to begin with?

Rex,

I'm fairly sure Dr. Emanuel would like to do the choosing for you. The heart of the issue, which Dr. Emanuel recognizes, is other people paying. When you take money from a third party to pay your bills they get a say in how that money is spent. Dr. Emanuel is advocating for cutting off most medicare spending on patients over 75.

My grandmother died in her mid-90's. She got to see four great-grandchildren. She was quite ill in her later years, per what the author wrote.

However, the author is an idiot to think that happens to everyone at 75. At 80 my grandmother was taking cruises with her children, participating in a theater group, part of a bridge group, and traveled frequently. Heck, she had a boyfriend!

To have cut her off at 75 would have been to eliminate about 14-15 YEARS of good health, world travel, visiting with family, and a variety of adventures.

At that age, you aren't guaranteed that you will fall into decline - even with medical issues. Silly assumptions. I have seen 60-year-olds who looked older and were in worse health than my grandmother was at 85. I have seen 80 year olds who looked 60.

It is silly to try to generalize these things.

Rex,

I'm fairly sure Dr. Emanuel would like to do the choosing for you. The heart of the issue, which Dr. Emanuel recognizes, is other people paying.

Maybe so. But if his main concern is cutting Medicare costs, why is he critical of "exercising, doing mental puzzles, consuming various juice and protein concoctions, sticking to strict diets, and popping vitamins and supplements"? Don't those cut down on the need for expensive medical care, or at least delay it?

From 1999, by the late Quentin Crisp (he was 90):

http://edikbcn.blogspot.com/2006/03/advantage-at-being-90by-quentin-crisp.html

Witty as always.

Excerpt:

"...Writers have often dreamed of immortality. Mr. Swift in Gulliver's Travels told us about the Struldbrugs, who devised a way of living long past their sell-by date. And what a pathetic sight they were. Then there was Mr. Shaw and his tragic Methuselah. If memory serves me right—and, of course, that is one of the first things to go—he lived for a thousand years, and what a curse that proved.This isn't a world for old people..."

As my grandfather reached his seventies, he began to plant trees. Trees that are beautiful today. He said he had a lot of making up to do, to replace those trees. I, too, might need that last couple decades to make up for my actions.

While I have no intention of being a burden, but last (wo)man standing, wins.

totally agree with 75 today. But it is this manic drive to extend life which has resulted in the above figure of 75 today. A 100 years back, the same person would have probably said 40 since all degeneration would have started by then and a 40 year old on 1914 would have been as fit as a 75 year old today.

I dunno Redrajesh, aging isn't so simple. Check out the ages on some of the Roman emperors (note quite a few were born BC and died AD, so don't forget to add instead of subtract to get ages). Heck, quite a few of them died of seriously non-natural causes at rather old ages.

http://en.wikipedia.org/wiki/List_of_Roman_emperors

I hope to die at 1000. By the time I reach 1000, I will have lived a complete life.

Logically, if someone claims living longer is 'bad', then they are either claiming one of two things:
1. Living shorter is good
2. There is an ideal 'sweet spot', i.e. an exact age at which it's bad to live longer or shorter than that

If they are claiming "1", then in fact they should commit suicide on the spot, as the shortest possible life is the best one.

If they are claiming there is a "sweet spot", then they must back that claim with some evidence that it is "ideal" in some universal sense. It's beyond absurd to even attempt to do so ... the rational inconsistencies multiply exponentially.

The reality is the average human lifespan is miniscule in any cosmic sense. I want to live long enough to see us settle other star systems. I want to live long enough to retire someday on a quiet settlement around Gliese 832, 16 light years from Earth.

75 years is a pathetic joke - can't do anything interesting with that.

Note the assumption that 'age = decline' only seems universal because it's all we know; however, that's ultimately largely just a question of technology. There is no known *inherent* reason why a human couldn't live to be thousands of years old, or even hundreds of thousands of years old, and still be perfectly healthy, given the appropriate coming progress in life extension methods.

The only real known physical limit is the eventual heat death of the universe.

For me quibbling about 75 or 85 or 100 is silly, that's just 'noise' - the questions are whether ~75 to 100 are better than 1000, or 100,000, or 1,000,000, or 10,000,000 years.

But obviously this is also subjective individual preference.

@"There is no known *inherent* reason why a human couldn't live to be thousands of years old"

(And yes I know about things like telomeres. That isn't what I mean ... telomeres are just another 'bio-engineering challenge that can and will be solved eventually. There's no known *intrinsically unsolvable* problem.)

How come they don't make "famous" people say it shorter? Annoying. ~ Posted by: Amy Alkon at September 21, 2014 9:55 AM

Takes too much effort to write a short piece.

"I would have written a shorter letter, but I did not have the time." ~ Blaise Pascal