The meaningfulness of life, not the length, is important.
That’s the message Ezekiel J. Emanuel, MD, PhD, says he was trying to convey when he wrote an essay that was published by The Atlantic in October. In a webinar with members of the media on Friday, the oncologist and bioethicist said he intended to start a conversation about aging and the end of life in the United States when he wrote the piece expressing his personal plan to forgo life-sustaining interventions when he is older, believing that they would be of limited benefit and would distract him from enjoying life. Emanuel’s writing certainly caught people’s attention, although he said he worries that the Atlantic editor’s chosen headline, “Why I Hope to Die at 75,” was so “provocative” that some would-be readers didn’t get past it.
“I hated that headline, and I came to blows with the editor, James Bennet, about it,” the vice provost at the University of Pennsylvania said in response to a question from me. “Mostly, what I want is for people to think about the meaningfulness, ‘What would make my life meaningful?’ rather than ‘What would make my life long?’ My philosophy, as you can see from the article, is not about dying.”
What gives life meaning, Emanuel said, is contributing to our families and our local and national communities—“the chance to enrich those around us”—rather than “adding up the years.” Quantity of life may or may not be associated with quality of life, added the former health policy adviser to the administration of President Barack Obama, and although human biology and culture encourage longevity, what most people value is quality.
The “Health Matters” webinar by ReportingOnHealth.org, an initiative of the USC Annenberg School of Journalism, had advice for journalists—be mindful that reports of greater happiness in late life usually involve research that excluded the less healthy seniors who are homebound or living in assisted living communities or nursing homes, he cautioned—but Emanuel’s message has implications for policymakers and healthcare professionals as well. He said we need to find ways to: