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.
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.
- “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).
‘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).
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.”
‘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 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.
He wrote, “Services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed.
A Matter of Life and DeathIn 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.
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.