Coming Soon: Longevity for the 1%, the "Choice" to Sacrifice for the Rest

[daredtowork]

I'm sure Ezekiel Emanuel was utterly sincere when he claimed he didn't wish to turn his personal philosophy into hard policy when he described why he hoped he hoped to die at 75: http://www.theatlantic.com/features/archive/2014/09/why-i-hope-to-die-at-75/379329/

However, by publishing his article in a prominent venue such as The Atlantic, it does seem like Emanuel wishes to influence the public conversation and lead opinion - and that could ultimately lead to policy. And there is no question Emanuel is trying to position the choice to end life at 75 as the morally superior one. Those who die at 75 will avoid a "low quality of life" and reduce the burden on their families, their communities, and the taxpayer. Emanuel snidely labels those who don't make this choice "American Immortals".

Let's not tiptoe around the real issue here. The U.S. has many apparent financial problems that need to be addressed by policy - cost of taking care of an aging population (including potential Social Security shortfalls), cost of health care, over-population and environmental issues, failing infrastructure. I say "apparent" because it's not always clear where we have a real problem and where the only problem is politics. One thing that is clear - Congress usually deadlocks on the major issues, and thus the problems-if they are problems-go unsolved.

In private people do freely opine their social engineering solutions to whatever they think the root of the problem is. One perennial favorite is the "over-utilization" of health care: especially by people who are elderly and "can't be saved". And there is always a little bit of grumbling about how this opinion can't be voiced out loud because it might offend someone's sweet Grandma. And there's always a weird ability to compartmentalize the "rational" argument from how you yourself might feel toward the end of your life, when others are deciding to allocate life-extending measures to you.

Sometimes, however, someone is so confident in the Rightness of their Vision, that they do "have the guts" to bring "what everyone is thinking" to the public podium. I've actually been waiting for this to happen. It just saddens me that the person who took out the bullhorn was Emanuel - someone who can be associated with the Affordable Care Act. Prepare for incoming Public Service Announcements about "Death Panels", "The Real Die Quickly", rationing, all sorts of right wing population control conspiracy theories, "Useless Eaters", and paranoid references to soylent green. If Emanuel is Obamacare's friend, it doesn't need enemies.

If anyone wants to get up to speed on why disguising State economic considerations as "choice" to die is fundamentally and morally wrong, I recently read a terrific dystopian novel on that very subject: Ninni Holmqvist's The Unit. In this book, if people aren't "needed" (by the labor force or by children) by 50, they are considered "dispensible". If they run out of resources to take care of themselves and aren't "protected" in some way, they go into the care of the State. In exchange for this "care", they gradually "donate" all their organs to the "needed" members of society. As society starts to run out of post-50 year olds the protected categories become fewer and fewer: since women are desperate to have children to become "needed", the babies are essentially eating the elderly in a monstrous social machine. This is one of the best novels I've read in recent memory. Here's a review: http://www.washingtonpost.com/wp-dyn/content/article/2009/06/29/AR2009062903971.html

While I was reading The Unit, I got a chill about our near future. When I read Emanuel, I realized that future is even nearer than a vague chill. An article from a respected Opinion Leader is how it all starts.

However, the biggest problem I have with Emanuel's pious proposition is that it is an egregious Entitlement of the 1%. No matter what he says now, when Emanuel reaches the age of 75, he really will have a choice about whether he wants to live longer or not. He's received the best of medical care all his life. He has a well-funded retirement. He might decide that his life is still worth living even if he's not "contributing" to the GDP in some way or coming up with ideas worthy of a Nobel Prize. The utilitarian standards he currently gives for the point of maintaining life are purely arbitrary: they are the standards of a State deciding whether you should live or die.

What about the people who have been set up to have a poor quality of life all along? Some of my genetic problems may have been caused by exposure to farming pesticides. Society imposed that element of poor quality of life on me: should I reward that by choosing to relieve society of my "burden" at age 75? There are many elements of "toxic stress" in the modern life style that don't just affect the poor: working conditions create muscle strain, eye problems, and even give people early heart attacks. People suffer this because they have to do what they have to do to earn a living. But if they become disabled through this struggle to survive, is society's answer going to be: "you should choose to die now"? I would argue the level of stress leading to disability would disproportionately effect the poor: and even with the Affordable Care Act, their medical resources to recoup their "quality of life" are nothing like what the 1% has access to.

Now let's look at another elephant in the room: longevity through technical advancement. Longevity promises have been in the air for decades. But so has a wink wink nudge nudge that only the very wealthy will have access to these longevity measures: it would be impractical to share because of the "population problem". (And let's face it - there's probably a little bit of snobbishness about IQ, class, and race in there, too). Under current conditions, longevity is for the rich only.

While Emanuel is framing the decision to die at 75 as a moral choice, it amounts to a sacrifice that the poor in particular will be made to make for the "good of society". This is the same as the "choice" to sign up for the military when there are no other jobs in the area. Even if there is a draft - the 1% finds ways to make themselves the exception. They don't have to sacrifice their "needed" sons for the good of society. Let the poor be cannon fodder.

If we as a society are ready to have a conversation about social engineering and population control, let's not do it with sneaky euphemisms and psychological manipulation. Let's state the problem up front: and if we're asking a particular social group to take one for the rest of the team, lets be honest about it. If that solution is sexist, racist, agist, and ultimately genocidal, let's be honest about that, too. But perhaps IF there is a real population problem here, it's enough to get our cowardly Congress to address it on the front end through family planning and birth control rather than pushing the people with a "low quality of life" (that may have been IMPOSED on them) into the sea!

What is Emanuel's mere opinion today will become propaganda and social pressure tomorrow: we the Democratic voters could easily find ourselves persuaded by "facts", statistics, and a deluge of editorials from respected public figures. It will all seem so reasonable and fair to the taxpayer when you vote for "choice" and "quality of life" and your "right to die". Then you will turn 50, and if you are unneeded, you will be escorted to The Unit for your retirement.

[PuraVidaDreamin]

1. Logan's Run?

Prophetic like 1984?

[daredtowork]

3. The Unit is scarily prophetic

Logan's Run, 1984, Brave New World - those all seem like "planned" dystopias. They are partially symbolic, and distanced from us so that they become more like thought experiments or conversation pieces than something we should be worried about in the near future.

The Unit is set in the very near present, and the terms of that world are all familiar. The protagonist definitely grew up in our world, where she acted on messages to pursue work she liked, try not to become dependent on a man, and don't have children unless you really wanted to have a family. Then political winds shifted out from under her, and what had previously been the "right" values turned out to be what doomed her.

While I was reading the book it seemed like this sort of future could be imminent. When I read Emanuel's article, I realized it could be tomorrow. Scary.

[Initech]

19. Elyisum is a far more likely scenario.

The uber rich get their own paradise in space. The rest of us get to inherit the earth that they created and subsequently destroyed.

[daredtowork]

22. I want to see that movie

I've been waiting for it to come on TV!

I agree there will be a gradual move toward defensible spaces. The most ironic part is even the rich who want to do their part and be "more than money" have protected themselves from being pestered, so only other rich people can go do "the ask" on behalf of good causes - which often involves paying some hefty fee to get into super-exclusive networking events. The beggar on the street only comes in contact with people who are close to falling into begging themselves, not the people who could set a homeless person up in an apartment with their pocket change.

Though you have to wonder: if the rich did depart for their own "paradise" and stopped sabotaging social policy with their vested interests, perhaps our political system would suddenly start working again!

[Louisiana1976]

2. Excellent essay. The dystopia described in The Unit sounds scary indeed. For, being over 50 (56,

to be exact) and childless I would be one of those deemed dispensable. Good thing that doesn't pertain in real life. For, as long as I am healthy, I want to live to be at least 100. And I'm on a fixed income and get my medical care through Medicare and Medicaid. If my continued existence bothers some Republican who considers me a "useless eater," that's their tough luck. They can pound sand. For I plan to enjoy life and vote Democratic as long as I can.

[daredtowork]

4. I can't recommend that book highly enough

One thing that is perpetually missing from our public policy is the idea that humans are valuable in and of themselves. They are not here "for the children" or "to contribute to society" or "for" anything - they are here to fulfill their own potential as human beings. But because we can't figure out how to factor that into policy, we keep grinding down quality of life - especially for those on the poorer side of the scale. Welfare policy is already skidding dangerously close to indirect genocide - the only reason it isn't is because people supposedly "move on" if they can't survive some place.

It infuriates me that people who have had so few options might be asked to "choose" to die because their quality of life is so low.

[davidthegnome]

5. Similar to the Eugenics movement...

I have heard that there is a similar academic movement today that goes by a different name, that pushes euthanasia, deliberate suicide and such things as, apparently, a form of "compassion".

I have to think of my own circumstances here. I was born into a middle class family, parents who worked hard for a living and earned enough money to support their family of five. High expectations for the children - college, professional careers, their own little homes and families and whatnot.

I was (and remain) sort of a black sheep for my family. I started struggling with intense anxiety issues as young as eight or nine, and was diagnosed with post traumatic stress disorder at 13. So, seventeen years or so, living with depression, anxiety attacks, all of the wonderful results of a post traumatic stress disorder... it's been one hell of a fight at times. I am certainly among the ranks of the working (very) poor, despite the fact that I was born into a life of seemingly greater advantage and entitlement.

GED educated, social and psychological issues... a working history that is perhaps not quite normal for a man my age. I wonder what these academics, these mighty intellectuals might suggest for me. Without the benefit of family support, I would have long since required state or federal assistance, medicaid, food stamps, rental and heating assistance and such. Had I had a considerably sized family, I would have required still more help. What a drain on society I might have been, how these noble academic nobles might have cringed.

Even now, as the season begins to turn, the days become shorter and the nights longer... it becomes darker and colder, and the old enemies (the ones in my head) step back up to remind me they're still there. Perhaps I should be encouraged to commit suicide, as I am undoubtedly a burden on society, on my family, on all of the wonderful orchestrations of this modern society. Perhaps I should opt to do the "moral" thing and fling myself from a cliff or something.

Yet... I think of others like me I have known, or those in worse circumstances. Good people, of humility, compassion, intellect, kindness. People who live their lives, who work hard, who some times fall down or fall through the cracks. People that it is has been my honor and pleasure to know. People for who's sake I would gladly step in front of a bullet or pay a few more bucks in taxes.

These intellectuals, these academics, these "genetically superior" little twits are, in truth, suffering from the notion of their own inferiority. It requires a very small person to try to tell others that they are unworthy or unfit for life, that they do not deserve to continue. I hope we all start living to one hundred and fifty just to piss them off.

Abraham Lincoln suffered from depression. Mozart, Enstein, Bethoven, Mother Theresa, Gandhi, all of these people suffered conditions under which some of these "intellectuals" would likely have promoted an end to their existence before they accomplished what we remember them for today.

Go fuck yourself, Emanuel.

[daredtowork]

6. I've always been vaguely suspicious of "right to die" movements for this reason

Though I can see how people might want control over their own bodies and dignity if they have terrible, painful diseases, I can't help thinking that their wish not to burden their families might be easily translated into pressure from their families to take their own lives.

I find it interesting that Emmanuel defines "contributing" in terms of winning a Nobel prize. I often wonder how many people could have won a Nobel prize if they had been offered the right opportunities and support in life. As I said in my OP, low quality of life is often an imposed condition. Toxic stress - which it seems you suffered from - can involved imposed conditions. Why should you die to relieve others of the burden of dealing with the consequences of your low quality of life when those conditions were imposed on you in the first place?

All that aside, who ever said (besides Emmanuel) that we were put on this Earth to "contribute" a Nobel prize anyway? What happens if people simply haven't come to value yet what we are contributing?

The levels of philosophical and ethical folly in his argument are strong.

[marions ghost]

12. Totally agree

A Nobel prize winner's life is worth no more than the ditch digger's.

They may receive more honors and even more satisfaction in life, but in the end, these categories don't matter.

It's how you have lived your life that counts, no matter your public accomplishments.

[daredtowork]

18. When you start talking about "contribution"

you not only have to ask who is holding the "measuring tape", but also who is this "contribution" ultimately benefiting? The greater profits of Walmart?

[marions ghost]

25. yeah --

I think we know who benefits from this thinking

[marions ghost]

13. You are not alone

My dad lived some dark days and a life similar to yours. Yet he persevered successfully for 85 years. Like you he had strong family support, but low-paying jobs. He made many friends and touched people because he understood that life is not easy for anyone. He gave empathy and he got empathy. Like you, he appreciated the intrinsic, the underfunded, the non-monetized aspects of life. He had a rich and full life and you will too because you are aware and know what is really valuable. In the end my Dad did not choose to leave the planet. He was having too good a time.

I have only one bone to pick from what you wrote. Please don't lump all "intellectual academics" in with this twit of an academic. You will find that many are caring and just as dismayed about all this as you are. If you have been hurt by labeling, don't do it. But certainly I understand why you'd go there. This guy is pukable. Yes a very small person, who will die without a clue. Sad, really.

[davidthegnome]

16. I don't.

I've known some pretty great intellectuals and academics. I have always though, mocked the ones who are too impressed with themselves. Pretentious, entitled, narcissistic, cruel and usually far too busy preening themselves to do much of any value.

I have known some of those, too, even psychiatrists who were much like that. Those that see symptoms, that see faults and failures and backgrounds and diagnostics before (and often without) seeing a person. If my struggles have taught me anything, it's that there is nothing grand and noble in living the perfect life, in doing everything right, in being a Nobel prize winner, a world renowned scientist, a mighty intellectual or a great politician - not in these things alone. No, to me, what makes one person bad or good is how they treat others, regardless of their station, their wealth, their intellect or strength. You've got assholes and wonderful people on both sides.

People far more intelligent than me once promoted eugenics and now promote the sort of thinking that Emanuel is pushing today. This idea that, based on one's apparent lack of financial contribution to society (much like those who consider different genetics inferior) they should ultimately do the "right" thing, and just die, before they cost anyone too much money.

I think that there is great value in humility. In recognizing the humanity within ourselves and the humanity within others, in recognizing that no one is without value, regardless of social circumstances, apparent wealth or apparent ability. There is something grand in just being a human being that gives a damn.

I have been hurt by labeling, but it hurts a lot less when I consider the other people I have known, who have been so labelled. Generally speaking, the holier, wittier, more intellectual than thou... well, my genuine feeling is that they can go fuck themselves.

[daredtowork]

20. Pseudo-Academics seem to Trump Real Academics

When an ideology like eugenics is promoted, it seem to have all the weight of academics behind it.

However, I often see studies emerge from the depth of academia that should have profound implication for social policy - but they get completely ignored because the scholars who produces them aren't "public intellectuals" or "opinion leaders". When it comes to conversion to policy, celebrity seem to carry more weight than years of research.

[marions ghost]

24. That is the problem

--if you dont have celebrity status you will be ignored...and that applies even to academia these days.

[daredtowork]

26. Which means all the Big Ideas are just kneejerk opinions

There needs to be a way for people to connect research and thorough study with the policy formation process.

[marions ghost]

23. OK --well said

[TBF]

7. There always seems to be money available to kill people -

as we see this week with the most recent war-mongering. Especially when people are profiting off of it. If they are not profiting off your long life than we can expect shorter lives. I'm not sure why a prominent democrat would publish something like this right before the midterms ... strikes me as incredibly stupid unless they are hoping to lose the senate.

[daredtowork]

9. The GOP answers to the same questions

are to enlist the extra people in the military so the extras get weeded out fighting their wars. Sorry if that sounds conspiratorial. I just think the Emmanuel's "choose to die for dignity's sake" is what they think is the "Democratic" reply to that. Fail.

[TBF]

14. I agree - more bipartisanship

they always seem to find a way to agree when it comes to screwing the working class.

[greatlaurel]

8. There is something seriously wrong with the Emmanuel brothers.

These men are really creepy and their views on society are completely twisted. The article is written by a man who lives in terror of not knowing he is superior to others. His concern about dying is so he does not have to face his decline in his mind. He is so twisted that he wants all those he considers lesser to be done away with. What a disturbing article.

davidthegnome, your post is very moving. Thank you!

[daredtowork]

10. His standard for contribution is "the Nobel Prize"

I think that says it all. He feels worthless if he's not Great. I've seen a lot of men with this syndrome. It's sad enough when they have it. They can't be allowed to impose it on the rest of it. Especially not at the cost of our lives. Especially not at the cost of the lives of the poor, where the "quality of life" measures will be focused!

[muriel_volestrangler]

11. However, "longevity through technical advancement" is what he's explicitly rejecting

and he says that groups that do have a short life expectancy, like black men, should get more treatment; and he singles out the high infant and adolescent mortality in the US as problems that deserve more attention:

As for the two policy implications, one relates to using life expectancy as a measure of the quality of health care. Japan has the third-highest life expectancy, at 84.4 years (behind Monaco and Macau), while the United States is a disappointing No. 42, at 79.5 years. But we should not care about catching up with—or measure ourselves against—Japan. Once a country has a life expectancy past 75 for both men and women, this measure should be ignored. (The one exception is increasing the life expectancy of some subgroups, such as black males, who have a life expectancy of just 72.1 years. That is dreadful, and should be a major focus of attention.) Instead, we should look much more carefully at children’s health measures, where the U.S. lags, and shamefully: in preterm deliveries before 37 weeks (currently one in eight U.S. births), which are correlated with poor outcomes in vision, with cerebral palsy, and with various problems related to brain development; in infant mortality (the U.S. is at 6.17 infant deaths per 1,000 live births, while Japan is at 2.13 and Norway is at 2.48); and in adolescent mortality (where the U.S. has an appalling record—at the bottom among high-income countries).

[Silent3]

15. Hey, don't go messin' with a good conspiratorial viewpoint!

The author couldn't possibly simply be advocating for something he believes in, he's got to be "in on it". And now you must be too!

[djean111]

31. If you read his body of work, and not just this article, you might see things a bit differently.

He believes universal care is bad because he is libertarian when it comes to providing health care.
He does not look at health care in terms of lowering costs and profits for private insurance, but in terms of limiting access.
He was an advisor to Obama for the ACA.

[Silent3]

32. Even with that being the author's philosophical bent...

...that's still a bit short of being evidence (or even good reason for mild suspicion, unless, of course, you are inclined toward conspiratorial thinking) that his article was written and published under the direction of Nefarious Powers as part of a Grand Scheme to persuade the rabble, en masse, to willingly die sooner and cheaper so that the elite can keep the best long-life healthcare to themselves.

[djean111]

33. Oh, I don't think he was doing anything at the behest of Nefarious Powers as part of a Grand Scheme,

that's a wee bit dismissive.
It bothers me that he has had a great deal of input into our health plans, though, and since he is all about the money, and the US is all about the money, I find it interesting to see what might happen down the road, keeping his philosophy in mind. You see, he quite likes it that some health care is too expensive for everybody. IMO, etc.

[woo me with science]

17. Suicides up with financial desperation

And there is a slow and quiet but steady stream of posts here, that echoes what I have heard from people out in 3d, that suggest a pistol and some good alcohol equal the last ditch retirement plans of many.


Middle-Age Suicide Rate Increase Leaves Health Experts at a Loss
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=103x339660

Suicide Rate Rises Sharply in U.S.
http://www.nytimes.com/2013/05/03/health/suicide-rate-rises-sharply-in-us.html

Financial crisis caused 5000 suicides
http://money.cnn.com/2013/09/18/news/economy/financial-crisis-suicide/index.html

GenXers: What Are YOUR Plans For Retirement Fund? http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x9727418

[daredtowork]

21. I think suicide is encouraged through inaction

There are a lot of things people secretly think "should" be done, but it's unthinkable to take overt action to do them. So instead they take no action, allowing some impossible or cruel state of affairs to remain, thinking that the fact they took no action absolves them of moral responsibility. This is the same thing as a lie of omission.

For instance, communities might refuse to use funds dedicated to low-income housing to build that housing in the secret hope the homeless will "move on" in the years of waiting. (I'm looking at you, Mayor of Berkeley!)

Or there might be "too many people on food stamps" in the area, so the procedure is complicated so it takes over a month to apply and people are regularly kicked off through bureaucratic errors that no one is accountable for. The secret thought is the county/taxpayers save money when starving people "move on".

People usually get desperate because they can't access resources. It's not just lack of access to "psychological services". People are being denied ways of getting their basic needs met, which corners them into suicide.

[woo me with science]

27. I agree. We are considered entries on a corporate ledger, not human beings

.

It is cheaper for us to die if we are not capable of adding to the bottom line profits. For a corporation, there is no guiding principle other than profit.

And it is a cruel joke to pretend that emotional desperation is anything but a sane response to an economic structure that deliberately makes necessities of life inaccessible.

[daredtowork]

28. The "Poor Make Bad Decisions" Meme Infuriates Me

Usually the poor have few to no options! They don't make "crazy decisions" - they make the decision that gets them what they need and/or seems manageable under the conditions they are in. They have to take into account things like access to transportation, appointment schedules, health issues/fatigue level, even whether they have access to clean clothing if a meeting seems crucial. The poor have to factor in things the rich just don't think about: they don't have an administrative assistant scheduling things and prioritzing for them. They can't take a vacation from the stress. All they can do is make the best decision with what they've got, and that's what they do every day.

The poor don't make bad decisions. The people who make decisions regarding the poor make bad decisions.

[True Blue Door]

29. The idea that a human being has to justify their right to exist

to the wider society and to a State is a hallmark of the ugliest and most heinous authoritarianism.

We have to shout the truth louder: That a State has to justify its right to exist to the individual, and never vice-versa.

A person is never expendable against their will; a State always is, regardless of its will.

[daredtowork]

30. Yes!

What a great way of putting it.