I should preface the body of my talk with a disclaimer. The following will mention the age 75. For those in the audience who are past this age, which includes my life partner, this may cause some discomfort. It is not my intention to cause discomfort, and I apologize to anyone made uncomfortable by my talk, but discomfort cannot be avoided when discussing end-of-life decisions. Also be aware that the age of 75 is not meant to apply to all persons, it is merely a starting point and is meant to be adjusted as fits each individual’s circumstances.
We are all shaped by our life experiences. Someone else has lived a different life than you have, has experienced different highs and different lows, and this accumulation of experiences frames the way we approach each new era in our lives.
I have to remember this when I hear someone in, say, their sixties, expressing concern about an elderly parent’s decline and end. The way their words catch in their throats reminds me that the trepidation, fear and angst they feel about the loss of their parent is sincere. I have to remind myself of this genuineness every time, and each time I do I am reminded of how different my own lived experience is from theirs.
In my case, and this is going to sound cold to some of you, I am relieved that my parents are now gone.
My mother handled the finances for my father’s business, and the first instances of her failing to deposit checks occurred in the late 1990’s. She took ill in 2000, and passed away, with Alzheimer’s, in 2006, by which time my father’s decline had started. When he passed away in 2019, it had been two decades.
During these years my siblings and I have dealt with putting our mother into a managed-care facility, selling the family home, moving our father to a smaller home, dealt with downsizing his possessions, dealt with doctors, hospitals, home health aides, the loss of my father’s driver’s license — and his refusal to recognize the necessity of this next chapter in his life — his declining mental and physical abilities, a heart attack, and his complete stubbornness to assist in, or even recognize the sacrifices of those who rearranged their lives to attend to his needs. For two decades, personal vacations were not used to travel to exotic corners of the planet, but were instead used to travel to the east coast to deal with lawyers, doctors, contractors, insurance officials, and even the homeowners’ association. In mid-2018 he came to live with my life partner and me, which was destressing for everyone involved. Within weeks after his arrival I called 9-1-1 for the first time in my life, and after eighteen months lost count of how many times we had to call them.
Decisions have consequences. The rest of my talk will be about a past decision and its consequences, and a future decision and its projected end result.
Of the challenges I’ve just described, much of them occurred in the last eight years of his life. When he was 89, he was rushed to a hospital, we were told that he had had a heart attack, and that a triple bypass was in order. I don’t remember even being asked whether we wanted to go ahead with it – it was all a blur. Any doctors in the audience might be thinking about standard operating procedures, directives, consent forms, and the like, but to my siblings and me, it was all a blur. They probably asked us whether we wanted to go ahead with the operation. If they did, we probably replied automatically, treating the question as a formality. Of course we authorized the doctors to go ahead; how could anyone say no? Yet we had no idea of the consequences, and this decision had consequences: years of suffering for the patient and everyone around him.
This is my life experience for the past two decades, and I carried this experience with me when I encountered an article in The Atlantic titled Why I Hope to Die at 75.
The writer, Ezekiel J. Emanuel, who was 57 when he wrote this, makes points aligned with the experiences I’ve described above, and also argues that the increased life expectancy over the past century, has not been added to the vibrant years of one’s retirement. Increases in life expectancy in recent decades has consisted not of reducing infant and child mortality, but of extending the lives of the old. The years that have been added to Western lives are years of declining physical and mental abilities, increased dependence on the charity of family and institutions, outliving one’s savings, and availing oneself of governmental programs. In other words, we now prolong the process of dying. Death, when it finally comes, is welcome.
It is true that death deprives us of experiences we value. But living too long forces us to endure events and conditions no one would ever choose for themselves or for anyone they love. We and those who love us have to endure the cessation of our contributions, our decline, and our becoming a burden.
Mr. Emanuel seeks to prevent this by, commencing at age 75, accepting only those medical interventions that will address his quality of life, while refusing those meant only to extend the duration of his life. He is not prescribing euthanasia or suicide, and in fact prescribes help for those in desperate situations. But he is rejecting the perpetual zeal to live as long as possible at all costs.
I agree with him.
Note: Here is one response to Emanuel’s article: https://www.theguardian.com/books/2016/oct/29/margaret-drabble-not-afraid-death-worry-about-living