Red Pill or Blue Pill?

Ezekiel Emmanuel doesn't want to live beyond the age of 75. That shouldn't really be anyone's concern besides his own, and, perhaps his immediate family's. 

Unfortunately, it is our concern, because Ezekiel Emmanuel isn't just some random guy, living in flyover country. He's Dr. Ezekiel Emmanuel, director of the Clinical Bioethics Department at the U.S. National Institutes of Health. He also heads the Department of Medical Ethics and Health Policy at the University of Pennsylvania. He's also one of the chief architects of the Affordable Care Act, otherwise known as Obamacare. 

So when Dr. Emmanuel says he doesn't want to live beyond the age of 75, after which he won't accept medical intervention for illness or use preventive health care screenings, and presents his reasoning in a lengthy article in The Atlantic called "Why I Hope to Die at 75," he's not just waxing poetic or nostalgic. He's shaping policy. He may claim otherwise ("I am not advocating 75 as the official statistic of a complete, good life in order to save resources, ration health care, or address public-policy issues arising from the increases in life expectancy"), but he's fooling nobody. 

On the heels of his piece in the Atlantic comes this article, "Panel Urges Overhauling Health Care at End of Life," in the New York Times reporting on the recommendations of (wait for it) The Committee on Approaching Death (I guess we need a committee for this). Their book, Dying in America: Improving Quality and Honoring Individual Preference Near the End of Life, contains the panel's recommendations. 

OK, so people who work with the elderly (and I know a few) might regard the committee's suggestions with equanimity. What's wrong with reimbursing health care providers for "conversations with patients on advance care planning?

Yet, from where I sit, it's impossible, when juxtaposing the seemingly benign suggestions of The Committee with Dr. Emmanuel's sunny rejection of old age, not to see where this is headed. And yes, I'm talking about that slippery slope. Good call, Ms. Palin.


That's how it works, folks. It begins with a "suggestion," moves into a "conversation," veers into debate, creeps into policy, seeps into mores, metastasizes into worldview. Before long, the right thing to do is not only to nudge the aged to choose an early exit, but to deprive them of the choice to extend their lives altogether, at least from the standpoint of insurance benefits. 

So here we are, 2014, in Obama's America. It is, as promised, fundamentally transformed. Ezekiel Emmanuel may be cool with it, and Michelle Obama, positively giddy. But, of course, that's what it's like when you're plugged into the Matrix. Peace and joy and light and sunshine and flowers. 

 The red pill for me, if you please, Morpheus.