Life and Health at 75

La CrosseEzekiel Emanuel, the director at the Clinical Bioethics Department at the U.S. National Institutes of Health, has a provocative piece in The Atlantic this month called “Why I Hope to Die at 75.” He writes:

…here is a simple truth that many of us seem to resist: living too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.

By the time I reach 75, I will have lived a complete life. I will have loved and been loved. My children will be grown and in the midst of their own rich lives. I will have seen my grandchildren born and beginning their lives. I will have pursued my life’s projects and made whatever contributions, important or not, I am going to make. And hopefully, I will not have too many mental and physical limitations. Dying at 75 will not be a tragedy. Indeed, I plan to have my memorial service before I die. And I don’t want any crying or wailing, but a warm gathering filled with fun reminiscences, stories of my awkwardness, and celebrations of a good life. After I die, my survivors can have their own memorial service if they want—that is not my business.

Of course, we can’t determine the age we’ll die and Emanuel says suicide is out of the question. But Emanuel says after 65, he’ll stop getting cancer screenings, and that he’ll only focus on getting palliative care rather than curative treatments. No more flu shots, no more antibiotics.

Though the title of his piece is provocative, many of us have planned out how we feel about the end of our lives without putting an actual age to it. Consider a story from Planet Money from earlier this year about a town that talks openly about death: Ninety-six percent of people who die in La Crosse, Wisconsin have an advance directive.

Nurses started asking patients questions like: If you reach a point where treatments will extend your life by a few months and side effects are pretty serious, would you want doctors to stop, or continue to do all that could be done? And a lot of patients said: Stop.

And stopping, of course, is less expensive than continuing treatment.

I probably wouldn’t openly say that I’d hope to die at 75—but I’d agree with having this kind of documentation that says “stop” if things get serious. Financial experts are always talking about how the cost of health care is the “wild card” in retirement planning, and it can be less so with some open discussions about it.

Photo of La Crosse: Payton Chung

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