Don't do it, Dr. Emanuel
In late September, Atlantic published a piece Dr. Ezekiel Emanuel, one of the chief architects of Obamacare, in which he described 75 as the ideal age to die and announced that when he reaches 75 he will eschew all preventive testing and any medical care, even antibiotics, that is not palliative.
He begins by noting the huge leap in life expectancy since 1900, when the average life expectancy was 47. In the first half of the twentieth century, the primary increases in life expectancy arose out of the introduction of penicillin and other antibiotics, as well as vaccines for childhood diseases, which had the effect of dramatically reducing deaths in childhood. Since 1950, the major jump in life expectancy has come from the ability to prolong life, which has resulted not only in another dramatic increase in life expectancy, but also in a significant increase in elderly Americans suffering from physical and mental disabilities. One-third of all Americans over 85, for instance, suffer from Alzheimer's. (Emanuel does acknowledge that seniors are healthier at every age than their counterparts of two generations ago; there are just so many more of them.)
Emanuel writes that were he to die at 75 (he is now 57) his daughters would be devastated by his death, just as he will be when his father, who is 87, passes on. But he wants them to remember him as still vigorous and not considerably diminished, as he views his father who can no longer do hospital rounds with his students.
He cites statistics that almost all great scientific discoveries are made by those in their forties or younger. Even a letter from an older colleague in which the colleague describes the pleasure that he now takes in mentoring younger colleagues and advising them on such issues as the proper balance between work and family is largely dismissed by Emanuel as reflecting a diminution of the scope of his ambition to change the world.
EMANUEL MAKES CLEAR that he is not advocating suicide or euthanasia; he will not act to end his life at 75 or any other age. (He also reserves the right to change his mind if and when he turns 75.) He is emphatically not Bethany Maynard, a 29-year-old woman with an inoperable brain tumor, who moved with her husband to Oregon and last week was the subject of a physician-assisted suicide, which is permitted in Oregon.
And in fairness to Emanuel, I suspect that most of us pray that we will not be a great burden to our children and are saddened when, after a lifetime of partnership, we witness one spouse functioning as a full-time caretaker of the other. Even here, however, one of the most interesting of the multitude of responses to Emanuel came from a writer named Cheryl Magness, whose elderly mother lives with her. She acknowledges that taking care of an elderly parent can often be challenging: She resents all the time that she must spend taking her mother to doctors, when she would rather be doing other things, is irritated by having to keep answering the same question, and describes her mother as often grumpy. Caring for her mother, she writes, forces her to confront her own selfishness on a daily basis.
But precisely for that reason she does not worry that she may one day become a burden for her children. Just as she views the sacrifices she made in the years spent raising her children as having helped her become a better, less selfish, more humble person -- recognizing that each of us is in some realm a weak being needing the help of others -- so too will her children become better people by virtue of "being so deeply needed by one who is weaker." They will gain a "chance to grow in compassion, responsibility, care and selflessness."
EMANUEL ANTICIPATES the arguments of those who responded to his essay by citing the examples of all those who remained creative and active until an advanced age. He mentions, for instance, an academic collaborator who continues to produce important academic papers in his eighties. He just doesn't want to count on being an outlier.
The real problem with Emanuel's essay lies not in his basis of evaluation, but in the whole effort to rank lives according to their productivity or ambition or by any other standard. It does not seem to occur to him that the loss of ambition to be "the one" to dramatically change the world, rather than reflecting decline, might instead be a manifestation of a greater wisdom and humility.
Once we define diminished physical prowess or declining mental acuity as something embarrassing and a state for which we would not wish to be remembered, then we are subtly conveying the message to the elderly or infirm that when they feel such a decline they should start preparing to shuffle off the stage and make way for the stronger and sharper.
More than a decade ago, the first American to orbit the earth, John Glenn, reprised his original space flight. The media was full of awe that a man his age retained the strength to withstand the gravitational pull of takeoff. An older man, according the prevailing view, is entitled to respect precisely to the extent he retains the vigor of youth.
But the Torah views the matter from an entirely different perspective. An older person deserves respect precisely because he is no longer thrall to his physicality and therefore his spiritual side has grown that much stronger. The white hairs that go with age reflect the draining of the physical life force so that the spiritual can shine forth in a much greater degree.
One of the joys of growing older is precisely the feeling that we are no longer dominated by our physical drives and that it is easier to exercise our bechirah under the guidance of our Divine seichel. As our physical side diminishes, our spiritual side grows in power.
As the Maharal (Be'er HaGolah, Be'er 6) puts it, "an older person, on account of breaking his body, is deserving of honor."
Now someone go tell Dr. Emanuel.
Uri Savir, co-founder of the Peres Center for Peace and the closest confidant of Shimon Peres, related the following incident in a recent encomium to the former president of Israel. "I once asked [Peres] if after thousands of hours of negotiations with the Palestinian leadership, he understood Palestinians better. He replied, 'No, I understand human beings better.'"
For Savir, of course, that quote represents further proof of Peres's deep insight. In fact, it is a classic example of one of the most pernicious fallacies of our times: The belief that culture and religion mean nothing, and that just under the skin all people are basically all alike.
Peres's Oslo adventure crashed on the shoals of that fantasy. He imagined a New Middle East in which peace between Israel and her neighbors would be cemented by flourishing trade and the rapid economic advance of the Palestinians and the neighboring Arab states. Thus in the heady early days of Oslo, Peres headed a large delegation to an economic delegation to a conference in Casablanca. His intent was to demonstrate the creativity and reach of Israeli industry and the potential for a win-win situation with Arab partners.
He had no clue of the honor-shame nature of Arab societies. In honor-shame societies there is no win-win: My enemy's advance must always be at my expense and vice versa. Victory consists of the enemy's humiliation. Thus the Arab papers the next day, according to Professor Mordecai Kedar, all reported that Israel intended to subjugate the Arabs and put them to work for Jews.
President Obama's entire Middle East policy, which now lies in shambles, was predicated on the refusal to take seriously Islam and its claims no matter how explicit. Thus the administration could describe the Moslem Brotherhood and even Hezbollah as moderate groups – i.e., their membership even includes doctors and lawyers – and even as largely secular. The only way in which they could be largely secular is if one ignores their charters and professed beliefs and assumes that all religious beliefs are really just a cover for what all men are assumed to value most highly – a larger slice of the economic pie.
With each passing day it becomes clearer that Obama's central foreign policy goal since coming into office was rapprochement with Iran at almost any cost. The administration chooses to ignore that Iran is a theocracy, with explicit goals dictated by its theology, and treats it instead as just another nation with "interests."
The fallacy that all people are basically the same may even explain how ostensibly rational people can rant and rave with apparent conviction that Israel is a genocidal apartheid state. They reason backwards from Palestinian suicide bombers. Since they would be unwilling to blow themselves up for the cause absent having been wronged in the most tangible and collective fashion, they reason that the Palestinians must have suffered such a wrong – after all, aren't all human beings basically the same.
Even ISIS gains sympathy under the same liberal dispensation. Paul Berman writes, "The spectacle of black-uniformed holy warriors conducting human sacrifices gives us the chills, but also makes us sigh. We tell ourselves: Here is what comes of failing to provide adequate social service to young men in blighted neighborhoods."
Surely, there must be a grievance to justify such barbaric cruelty, for as Berman explains, the first liberal reaction is to believe that if decent people just appeal the decency latent in others, all be ultimately be well."
Sadly, the world does not work like that.