Dr. Ezekiel Emanuel’s War Against the Elderly

September 21, 2020 Updated: September 23, 2020


No group of Americans has been more deleteriously affected by the COVID-19 pandemic than our elderly. For younger people without significant preexisting health conditions, the novel coronavirus usually comes and goes without serious consequences.

But for the elderly—particularly the frail and those with comorbidities—it’s a terrible killer.

Indeed, according to the U.S. Centers for Disease Control and Prevention, the risk of death for COVID-19 patients aged 65 to 74 is 90 times higher when compared to the risk of death for COVID-19 patients ages 18 to 29. The risk of death for patients 75 to 84 is 220 times higher. And get this: For patients age 85-plus, the risk of death is a staggering 630 times higher.

So, we know who is most at risk, a fact that should be kept in mind when a vaccine first becomes available—hopefully soon—because initially there won’t be enough doses to go around. This means that a formal triage system of distribution will have to be established that may last many months, that is, until enough doses are manufactured to inoculate everyone who wants a jab.

Considering the risks of serious morbidity or death from the disease, the elderly should be placed at the front of the line (along with health care workers and others essential to the smooth running of society). Indeed, that is the draft framework distribution plan announced recently by the National Academy of Sciences, which gives “first-tier” priority to:

  • “Those most essential in sustaining the ongoing COVID-19 response” (e.g., frontline health workers, etc.),
  • “Those at greatest risk of severe illness and death, and their caregivers” (e.g., adults older than 65; others at elevated risk of serious COVID-19 and complications), and
  • “Those most essential to maintaining core societal functions” (e.g., workers in frontline public transport, food supply, and schools).

If we believe in the equal moral worth of all human beings, this is an eminently reasonable approach. Unfortunately, not everyone sees the elderly as deserving priority protection, most notably bioethicist and Obamacare architect Dr. Ezekiel Emanuel.

‘Premature Deaths’

In contrast to the NAS proposal, Emanuel—who is a key Joe Biden health care adviser and potential nominee to be secretary of Health and Human Services—would impose what he calls a “Fair Priority Model” internationally. Under this system, the first doses of the vaccine would be distributed to younger people—including those in other countries— to prevent what bioethicists are calling “vaccine nationalism” (a subject beyond our scope here).

Writing in Science magazine, Emanuel argued that instead of protecting those at most risk of death, the focus should be instead on preventing “premature deaths,” that is, dying before one’s life expectancy. This, even though such people are at materially less risk of death from COVID-19 than the elderly.

Why? Essentially, Emanuel thinks that the lives of younger people matter more than our elders, writing: “A premature death that prevents someone’s exercising their skills or realizing their goals later in life is worse than a death later in life. Ethicists have similarly argued that preventing early deaths—deaths that are more prevalent in poorer countries—is both prudent and ethical.”

In other words, Emanuel advocates that people with far less chance of falling seriously ill and dying—whether in the United States or overseas—should have priority over the elderly who are most at material risk because their lives are just not as important.

‘Living Too Long’

This isn’t the first time Emanuel has expressed invidiously ageist attitudes. He is infamous for arguing a few years ago in The Atlantic that he wanted to die at age 75—strongly implying we all should, too—promising to forego medical interventions such as flu shots and life-sustaining treatment once he became old.

Why? Because by then, one’s productivity and ability to contribute to society has shriveled.

He wrote: “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.”

He added that decline by age 75, “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.”

Good grief. Does he think we are really that crass? I can tell you that’s not how I think of my mother, uncle, and aunt, all of whom died after growing frail from advanced age (99, 91, and 91, respectively). I treasure every moment of their final years, including as my mother’s primary caregiver for the last five months of her life. My mother and uncle both died of the effects of Alzheimer’s, and my aunt of simple frailty in old age. In no way were any of them “pathetic!”

How could he be so disdainful of the elderly? Emanuel has long embraced what is known in bioethics as the “quality of life” ethic. In contrast to the sanctity/equality of life approach, those who think like Emanuel believe that elderly people experiencing the debilitations of age (among others) have a lower moral value than younger and healthier people.

In fact, long before COVID-19 was a dark cloud on the Chinese horizon, Emanuel argued in the Hastings Center Report that health care services considered “basic” should be societally guaranteed for the young and productive, but not for the seriously disabled and elderly.

He wrote, “Services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed.

An obvious example is not guaranteeing health services to patients with dementia.” Wow.

A Matter of Life and Death

In this regard, it’s also worth noting that last month, Emanuel was the lead signatory in an open letter signed by “experts” urging a second complete government shutdown. Relevantly, those most deleteriously impacted by societal shutdowns are elderly people in nursing homes.

Indeed, Politico reported that “deaths attributed to Alzheimer’s disease and dementia rose to more than 20 percent above normal over the summer,” furthered by “increased isolation and stress during lockdown.”

In other words, shutdowns lead to institutionalized elderly people literally dying of loneliness. Not that Emanuel seems to have given this aspect of the COVID-19 tragedy much thought.

Why should we care what Emanuel thinks? Simple. The bioethicist exerts tremendous influence in the world of bioethics generally—the experts often relied on to decide health care public policy—and with Biden and among Democrats, in particular.

That means, if you have a loved one who could be put at lethal risk from Emanuel’s invidious attitudes against the elderly, the pending election could be literally a matter of their life and death.

Award-winning author Wesley J. Smith is chairman of the Discovery Institute’s Center on Human Exceptionalism. His latest book is “Culture of Death: The Age of ‘Do Harm’ Medicine.”

Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times.