A Duty to Die

[rsbs]

Obama's architect on Obamacare speaks out. Now it's not just the unborn babies....they are coming for Bruce, Slowboat, Canuckfool, and Obnoxious, as well as the rest of us eventually, too.

The Corner

Health Care

Pushing ‘Healthspan’ Duty to Die for the Elderly?

By Wesley J. Smith

• About Wesley J. Smith
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September 21, 2018 5:51 PM

The bioethicist and Obamacare architect, Ezekiel Emanuel, made headlines — and raised hackles — when he argued a few years ago that 75 is the right age to die, or at least, to stop fighting medically to extend life.

Now in “From Lifespan to Healthspan,” published by The Journal of the American Medical Association (JAMA), University of Illinois professor S. Jay Olshansky argues that it is time to shift medicine’s focus — starting at age 65 — away from “life extension” to maintaining quality of life or years of healthy living, which he calls “healthspan”:

With death inevitable, the modern attempt to counteract aging-related diseases reveals a phenomenon known as competing risks. When the risk of death from a disease decreases, the risk of death from other diseases increases or becomes more apparent. . . . For example, finding a cure for cancer may cause an unintended increase in the prevalence of Alzheimer disease.

The inescapable conclusion from these observations is that life extension should no longer be the primary goal of medicine when applied to people older than 65 years of age. The principal outcome and most important metric of success should be the extension of healthspan.

It is one thing if a patient decides to make healthspan the primary focus of his or her medical care. But it would be quite another for the system to require that approach through rationing laws, insurance-coverage guidelines, or ethical directives to doctors.

Indeed, lurking ominously between the lines of these discussions is a bioethical concept known as the “duty to die.” Proposed most (in)famously by bioethicist John Hardwig in 1997 in the Hastings Center Report — the world’s most prestigious bioethics journal — the duty to die seeks to prevent people who have lived complete lives from becoming burdens on themselves, their families, and society. From, “Is There a Duty to Die?”

1) A duty to die is more likely when continuing to live will impose significant burdens — emotional burdens, extensive caregiving, destruction of life plans, and, yes, financial hardship.

[rsbs]

and loved ones. This is the fundamental insight underlying a duty to die.

Comments

2) A duty to die becomes greater as you grow older. As we age, we will be giving up less by giving up our lives, if only because we will sacrifice fewer remaining years of life and a smaller portion of our life plans . . . To have reached the age of, say, seventy-five or eighty years without being ready to die is itself a moral failing, the sign of a life out of touch with life’s basic realities.

3) A duty to die is more likely when you have already lived a full and rich life. You have already had a full share of the good things life offers.

Most bioethicists who denigrate the equal importance of the lives of the elderly and/or who promote age-based health-care-rationing schemes are not as explicit or impolitic in their advocacy as Hardwig. But changing the “primary goal of medicine” to “healthspan” — if involuntary or based on policy — would come perilously close to justifying that same utilitarian end.

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[r3020]

It's the duty of the little people. The elite will exhaust every option known to man before they go. This is how socialist pay for their plans.

[rodgersfarms56]

Just a question to ponder. If we discovered for 10,000 dollars per week we could keep old folks alive to the age of 100 would you want our kids spending 80 percent of their income to do it? Would you keep taking ss until you were 100? When I hear old people say they paid for their ss so by damn they want it, it sickens me. When Social Security began the life expectancy was 65 meaning half would never draw. I suppose Medicare or insurance should keep old folks alive whatever the cost. I got news for you. If there are two million people who have their homeowners insurance with the same company as you and everyone’s house burns down the same night, you are not getting paid. Old folks ask government to (through Medicare) keep them alive forever with methods never envisioned so they can draw Social Security for decades with a Social Security program that was meant only to payout for the handful (the anomaly) who lived that long. Old people and children can be really selfish.

[schnurrbart]

You finally admit that genocide is high on the repuke *****’s list of things to do. Well ***** you *****!

[rodgersfarms56]

Incoherent. Too many missing words. My post was about reality not advocating any policy. If medical science allows how hard do you want our children and grandchildren to work to keep us living (if you call it that) to 100 or 110? Just answer the damn question.

[AllenJwi]

Pull your plug Bart. Your time is up !

[AllenJwi]

Your a supporter of Soylent Green? https://www.youtube.com/watch?v=Vf6bQ_5_q24

[schnurrbart]

Little al you folks are talking about taking much of seniors healthcare away which will mean that many will die before their time.

[wehav]

A common error using statistics "When Social Security began the life expectancy was 65 meaning half would never draw. "

Life expectancy has been an average, i.e. mix all the people that died at a certain age and divide by that number.  The old cemeteries have multiple graves of babies and small children that died.  Those same cemeteries also have many graves of people that lived to their 80's and 90's.  Past history showed that many of the young died young from disease that vaccinations coupled with modern medicine has changed.  We've now saved a baby who was 21 weeks 4 days old.  Years ago we lost full term babies.

My ancestors lived into their 80's and 90's, and like me were still working in their 70's.