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Statement Of Fred H. Rubin
Environmental Protection Agency
Aging Initiative Public Listening Session
Pittsburgh, Pennsylvania
April 23, 2003
Fred H. Rubin, M.D.
FACP, FRCP (C)
University of Pittsburgh School of Medicine
FACP, FRCP (C)
University of Pittsburgh School of Medicine
Thank you for the opportunity to appear here today to express my views regarding the Clear Skies Initiative. I am a practicing physician in Pittsburgh specializing in Geriatric Medicine, the care of the elderly. I am a Professor at the University of Pittsburgh School of Medicine, and Chairman of the Department of Medicine at Shadyside Hospital, a major teaching hospital of the University. Although I have been concerned about the quality of the air we breathe since I took my first course in Public Health over 30 years ago, today I wish to address the issue of the value of the life of a person over age 70.
Under the proposed Clear Skies legislation, such a life would be valued at only 63% the worth of a younger person. Under this sort of cost-benefit analysis, the value of a person is determined by their ability to be productive in the work force. It ignores the value of a life to other family members, to spouses, children, and grandchildren. It ignores the community benefits that older people bring, such as volunteering in community agencies, religious organizations, or political parties. The specific figure of 63% comes from a British study which has been widely discredited. While economists might argue over the proper number, we need to remember that we do not live in an economy, but in a society. Our society, the United States of America, is founded upon a set of basic principles, one of which is that everybody's life is of equal worth. We do not discriminate based upon race, religion, gender, personal wealth, or age. Our nation has been willing to go to war to defend this principle.
Nobody can judge the value of somebody else's life. As a practicing physician, I am involved every day in situations where seniors might be denied life-enhancing or life-sustaining therapies solely on the basis of age. Fortunately, modern Medicine recognizes that the only valid criterion for judgment is the biological health of the individual person, not some arbitrary age. Decades ago, it is true that our health system refused treatment to some people just because they were past a certain age. Now we know from an overwhelming body of scientific research that such exclusions cannot be justified. For example, one of the most commonly performed operations in large hospitals these days is coronary artery bypass grafting, or "open heart surgery". The average person in Pittsburgh undergoing this procedure is over age 65. Yet just 25 years ago, being over 65 was an exclusionary criterion for this surgery!
I urge you to eliminate the concept of an older person's life being of less worth than someone younger. This is an obsolete notion that is morally indefensible and biologically just plain wrong. Thank you.