A Good Day to Die?F. Amos Bailey, MD Aug 23, 2018
Zeke Emanuel, a famous physician-ethicist, has widely written and spoken about his hope to die at 75. He does seem to be something of a showboat, announcing this hope 4 years ago in an article in The Atlantic, much to the consternation of family and friends. When you get past the intentional shocking proclamation you learn of his caveats.
Zeke’s date with death is still 15 years off. He has no intention of hastening his own death. Primarily he is planning to stop seeking to avoid illness and death, such as cholesterol medication, colonoscopy, although I am not clear on vaccinations and antibiotics if needed. His point is that he will have lived a good life and that he is not looking forward to a life of growing dependency and declining health. He has seen many patients who he thinks have had their lives extended a bridge too far.
Zeke has all the advantages. He has a safe home, good food, a supportive family, income and many of the other social determinants that portend a good chance that he will live at least to 75, if not well past that in pretty good health. He is a part of the 1%. What about the other Americans, some living around the University of Pennsylvania, where he works, who have few of the advantages and will feel lucky to live to 75. Frankly, I am haven’t had a lot of sympathy for his concern in the light of worsening disparity.
Lyssa Weatherly MD, recently wrote an essay called A Beautiful Death in which she recounts a man in his 90’s living in a nursing home who was admitted to her hospital in Mississippi. On the day of discharge he announces his premonition of his impending death and that he is at peace and ready to meet his maker and be joined again to his wife. His discharge is held, and he does start to decline, has comfort focused care and dies with his family around him within 24 hours. Perhaps this is what Zeke is aspiring to.
Palliative Care is an appropriate adjunct to healthcare not an alternative.