In October 2014, Ezekiel Emanuel, a noted bioethicist from the University of Pennsylvania, authored an op-ed piece in The Atlantic titled, “Why I Hope to Die at 75.” While Dr. Emanuel provides a clear argument to support his view, this controversial article—which takes a one-two punch at the field of gerontology—falls short in its misrepresentation of the goals of aging research and its damaging portrayal of individuals who have succeeded in surviving to old age. Dr. Emanuel suggests that the desire to extend life, which he attributes to the aspirations of a cultural archetype he terms the “American Immortal,” is destructive. He describes living “too long” as a “loss” which “renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived.”
This statement is a quintessential example of what is commonly referred to as “ageism,” a damaging form of prejudice which unfortunately remains pervasive today. Ageism has been shown to reinforce discriminatory practices in the workplace and in social settings. There is also evidence to suggest that it may contribute to reductions in self-esteem and increased stereotype threat. While other forms of discrimination, such as sexism and racism, are viewed as morally inexcusable in modern day society, ageism has remained socially acceptable to the point where Dr. Emanuel uses it as the basis for his policy proposal.
In his article, Dr. Emanuel refers to a study published by Dr. Eileen Crimmins, a professor at the USC Leonard Davis School of Gerontology, and her former post-doc, Dr. Hiram Beltrán-Sánchez, to substantiate his negative depiction of older adulthood. Although he does rightfully acknowledge population variance and the existence of outliers, Dr. Emanuel’s interpretation and presentation of the demographic findings are misguided. He points out that Crimmins and Beltrán-Sánchez show that over the last two decades there has been an increase in life expectancy with disease and disability. Based on this finding, Dr. Emanuel proclaims, “American immortals may live longer than their parents, but they are likely to be more incapacitated.”
Yet what he fails to mention is that while the prevalence of heart disease, cancer, and diabetes among individuals aged 80 has increased, rates remain below 30%. Additionally, Crimmins and Beltrán-Sánchez note that while prevalence has increased, these diseases have also become less debilitating. Thus Dr. Emanuel’s scare tactic, claiming that most of us are likely to live out the majority of our golden years in a state of incapacitation, is unmerited.
In addition to presenting an argument for the cessation of healthcare at age 75, Dr. Emanuel also argues for limiting funding for research with the goal of extending lifespan and instead advocates for increasing investments in research on chronic diseases. What he fails to recognize is that the biological aging process is the largest risk factor for most major chronic conditions. The complex progressive decline that our bodies undergo with age contributes to a number of alterations in cellular structure and functioning. Subsequently, these are often directly responsible for the increasing susceptibility to a number of chronic conditions with age.
Ironically, Dr. Emanuel’s editorial is more an argument for, rather than against, longevity research. Instead of investing in disease-specific projects as Dr. Emanuel suggests, we need to devote more resources towards understanding the molecular and environmental mechanisms that regulate aging and lifespan. Like many other scientists, I propose that this is likely the only way we will have a chance at postponing or even eliminating the conditions which ultimately degrade our bodies and minds.
Editor’s note: The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the USC Leonard Davis School of Gerontology.