Ezekiel Emanuel is an American oncologist and bioethicist and senior fellow at the Center for American Progress. He is the current Vice Provost for Global Initiatives at the University of Pennsylvania and chair of the Department of Medical Ethics and Health Policy.

Previously, Emanuel served as the Diane and Robert Levy University Professor at Penn. He holds a joint appointment at the University of Pennsylvania School of Medicine and the Wharton School and was formerly an associate professor at the Harvard Medical School until 1998 when he joined the National Institutes of Health.

Ezekiel Emanuel Family

Emanuel is the son of Benjamin M. Emanuel and Marsha, Emanuel. His father, Benjamin M. Emanuel, is a Jerusalem-born pediatrician who was once a member of the Irgun, a Jewish paramilitary organization that operated in Mandate Palestine. He provided free care to poor immigrants and led efforts to get rid of lead paint due to its negative consequences for children and as of 2010 lived in a suburb of Chicago.

Emanuel’s mother, Marsha, a nurse and psychiatric social worker who was raised in the North Lawndale community on Chicago’s West Side, was active in civil rights, including the Congress of Racial Equality (CORE). She attended marches and demonstrations with her children. In a 2009 interview, Emanuel recalled that in his childhood “worrying about ethical questions was very much part and parcel of our daily routine.

Ezekiel Emanuel Wife

Emanuel is a divorced father of three daughters. He was married to Linda Emanuel from the year 1983 to 2008 when they divorced.

Ezekiel Emanuel Children

His daughter Gabrielle, a 2010 graduate of Dartmouth College, won a Rhodes scholarship in November 2010. His daughter Rebekah, a graduate of Yale University won a George J. Mitchell Scholarship in 2008. Another daughter Natalia, a 2013 graduate of Yale University, won a Marshall scholarship in November 2013 and is currently a Ph.D. student at Harvard University.

Ezekiel Emanuel Education

Emanuel graduated from Amherst College in 1979 and subsequently received his M.Sc. from Exeter College, Oxford in Biochemistry. He simultaneously studied for an M.D. and a Ph.D. in Political Philosophy from Harvard University, receiving the degrees in 1988 and 1989, respectively.

He was a member of the first cohort of Faculty Fellows at the Edmond J. Safra Center for Ethics at Harvard from 1987–88.[13] Emanuel completed an internship and residency at Beth Israel Hospital in internal medicine. Subsequently, he undertook fellowships in medicine and medical oncology at the Dana–Farber Cancer Institute and is a breast oncologist. Emanuel received dozens of honors and awards, including the Toppan Dissertation Prize, the Harvard award for best political science dissertation of 1988.

Ezekiel Emanuel Quotes

  • Childhood vaccines are one of the great triumphs of modern medicine. Indeed, parents whose children are vaccinated no longer have to worry about their child’s death or disability from whooping cough, polio, diphtheria, hepatitis, or a host of other infections.
  • Vaccines are the most cost-effective health care interventions there are. A dollar spent on a childhood vaccination not only helps save a life but greatly reduces spending on future healthcare.
  • Physician-assisted suicide and euthanasia have been profound ethical issues confronting doctors since the birth of Western medicine, more than 2,000 years ago.
  • I’m the son of a pediatrician, and I do believe that the most important resource we have is our kids. And I think the most important thing for America’s future is to invest more in our children.
  • Americans tend to endorse the use of physician-assisted suicide and euthanasia when the question is abstract and hypothetical.

Ezekiel Emanuel Books

  • The Trillion Dollar Experiment: A Decade of the Affordable Care Act
  • Prescription for the Future: The Twelve Transformational Practices of Highly Effective Medical Organizations
  • Reinventing American Health Care: How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System
  • Brothers Emanuel: A Memoir of an American Family
  • Healthcare, Guaranteed: A Simple, Secure Solution for America
  • The Oxford Textbook of Clinical Research Ethics
  • No Margin, No Mission: Health Care Organizations and the Quest for Ethical Excellence
  • The ends of human life

Ezekiel Emanuel Career

After completing his post-doctoral training, Emanuel pursued a career in academic medicine, rising to the level of associate professor at Harvard Medical School in 1997. He soon moved into the public sector and held the position of Chief of the Department of Bioethics at the Clinical Center of the U.S. National Institutes of Health. Emanuel served as Special Advisor for Health Policy to Peter Orszag, the former Director of the Office of Management and Budget in the Obama administration.

Emanuel entered the administration with different views from President Barack Obama on how to reform health care but was said by colleagues to be working for the White House goals. Since September 2011, Emanuel has headed the Department of Medical Ethics & Health Policy at the University of Pennsylvania, where he also serves as a Penn Integrates Knowledge Professor, under the official title Diane S. Levy and Robert M. Levy University Professor.

Ezekiel Emanuel Net Worth

Emanuel has an estimated net worth of $100k US dollars.

Ezekiel Emanuel Healthcare

In articles and in his book Healthcare, Guaranteed, Emanuel said that universal health care could be guaranteed by replacing employer-paid health care insurance, Medicaid and Medicare with health care vouchers funded by a value-added tax. His plan would allow patients to keep the same doctor even if they change jobs or insurance plans. He would reduce co-payments for preventive care and tax or ban junk food from schools. He criticized the idea of requiring individuals to buy health insurance. However, he supports Obama’s plans for health care reform, even though they differ from his own.

In the article Why Tie Health Insurance to a Job? Emanuel said that employer-based health insurance should be replaced by state or regional insurance exchanges that pool individuals and small groups to pay the same lower prices charged to larger employers.

Emanuel said that this would allow portable health insurance even to people that lose their jobs or change jobs, while at the same time preserving the security of employer-based health benefits by giving consumers the bargaining power of a large group of patients. According to Emanuel, this would end discrimination by health insurance companies in the form of denial of health insurance based on age or preexisting conditions.

In Solved!, Emanuel said that Universal Healthcare Vouchers would solve the problem of rapidly increasing health care costs, which, rising at three times the rate of inflation, would result in higher copayments, fewer benefits, stagnant wages and fewer employers willing to pay for health care benefits.

In an article co-written by Ezekiel Emanuel and Victor Fuchs, Emanuel co-wrote that employer-based health insurance has “inefficiencies and inequities”, that Medicaid is “second-class” and that ensuring more people without replacing those systems would be to build on a “broken system”. He said, “in the short run they require ever more money to cover the uninsured, and in the long run the unabated rise in health costs will quickly revive the problem of the uninsured.” He suggested that a federal agency be created to test the effectiveness of new health care technology.

Ezekiel Emanuel Ends of Human Life

In his book, The Ends of Human Life Emanuel used the AIDS patient “Andrew” as an example of moral medical dilemmas. Andrew talked to a local support group and signed a living will asking that life-sustaining procedures be withdrawn if there is no reasonable expectation of recovery.

The will was not given to anyone but kept in his wallet, and no one was given power of attorney. There were questions about his competence since he had AIDS dementia when he signed the will. Still, Andrew’s lover said that he had talked about such situations, and asked that Andrew be allowed to die. Andrew’s family strongly disagreed that Andrew wanted to die.

Dr. Wolf previously saved Andrew’s life, but promised to help him avoid a “miserable death”. The ICU wanted guidance from Dr. Wolf as to how aggressively they should try to keep Andrew alive, as his chances of surviving a cardiac arrest were about zero. Two other critical patients were recently refused admission because of a bed shortage. There was a question as to whether Andrew’s lover was representing Andrew’s wishes or his own.

There was also a question as to whether Andrew’s parents knew Andrew better than others, or whether they were motivated by guilt from rejecting Andrew’s identification as a gay male. The cost of aggressive treatment was $2,000 per day.

This dilemma illustrates the ethical challenges faced by even the most conscientious physicians, in addition to patient confidentiality, the meaning of informed consent, and the ethics of experimental treatments, transplanting genes or brain tissue. Also, while many agree that every citizen should be given adequate health care, few agree on how to define what adequate health care is.

Many of these issues have become almost insoluble moral dilemmas. Babies that would be born with serious birth defects pose a serious moral dilemma, and medical technology makes it sometimes difficult to define what death is in the case of permanently brain-damaged patients on respirators. There are also ethical questions on how to allocate scarce resources. However, the Hippocratic Oath is proof that medical technology is not the cause of medical questions about ethics.

Emanuel said the Hippocratic Oath and the codes of modern medical societies require doctors to maintain client-patient confidentiality, refrain from lying to a patient, keep patients informed and obtain their consent, in order to protect the patient from manipulation and discrimination.

Emanuel said that a doctor’s oath would never allow him to administer a lethal injection for capital punishment as a doctor, although the issue would be different if he were asked to serve on a firing squad not as a doctor but rather as a citizen. He said that in the case of mercy killing there are rare cases where the medical obligation to relieve suffering would be in tension with the obligation to save a life and that a different argument would be required instead.

Ezekiel Emanuel legalization of euthanasia

Emanuel said that legalizing euthanasia, as was done in the Netherlands, might be counterproductive, in that it would decrease support for pain management and mental health care. However, Emanuel does support the use of Medical Directives to allow patients to express their wishes when they can no longer communicate.

Ezekiel, and his former wife Linda Emanuel, an M.D. Ph.D. bioethicist and geriatrician, created the Medical Directive, which is described as more specific and extensive than previous living wills and is a third-generation Advance Directive. He claims the Hippocratic Oath debunks the theory that opposition to euthanasia is modern.

Emanuel said that for the vast majority of dying patients, “legalizing euthanasia or physician-assisted suicide would be of no benefit. To the contrary, it would be a way of avoiding the complex and arduous efforts required of doctors and other health-care providers to ensure that dying patients receive humane, dignified care.”

Emanuel said that a historical review of opinions on euthanasia from ancient Greece to now “suggests an association between interest in legalizing euthanasia and moments when Social Darwinism and raw individualism, free markets and wealth accumulation, and limited government are celebrated.”

He said that it is a myth that most patients who want to die to choose euthanasia because they are in extreme pain. Emanuel said that in his own experience, “those with pain are more likely than others to oppose physician-assisted suicide and euthanasia.” He said that patients were more likely to want euthanasia because of “depression and general psychological distress … a loss of control or of dignity, of being a burden, and of being dependent.”

He also said that the kind of legalized euthanasia practiced in the Netherlands would lead to an ethical “slippery slope” which would make it easier for doctors to rationalize euthanasia when it would save them the trouble of cleaning bedpans and otherwise caring for patients who want to live. He said that legalized euthanasia in the Netherlands did not adhere to all the legal guidelines and that some newborns were euthanized even though they could not possibly have given the legally required consent.

As Emanuel said, “The Netherlands studies fail to demonstrate that permitting physician-assisted suicide and euthanasia will not lead to the nonvoluntary euthanasia of children, the demented, the mentally ill, the old, and others. Indeed, the persistence of abuse and the violation of safeguards, despite publicity and condemnation, suggest that the feared consequences of legalization are exactly its inherent consequences.”

Ezekiel Emanuel Death panels

Betsy McCaughey described Ezekiel Emanuel as a “Deadly Doctor” in a New York Post opinion article. The article, which accused Emanuel of advocating healthcare rationing by age and disability, was quoted from on the floor of the House of Representatives by Representative Michele Bachmann of Minnesota.

Sarah Palin cited the Bachmann speech and said that Emanuel’s philosophy was “Orwellian” and “downright evil”, and tied it to a health care reform end of life counseling provision she claimed would create a “death panel”. Emanuel said that Palin’s death panel statement was “Orwellian”.

Palin later said that her death panel remark had been “vindicated” and that the policies of Emanuel are “particularly disturbing” and “shocking”.On former Senator Fred Thompson’s radio program, McCaughey warned that “the healthcare reform bill would make it mandatory—absolutely require—that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner.

Ezekiel Emanuel Storm of Overutilization

In the 2008 Journal of the American Medical Association article “The Perfect Storm of Overutilization”Emanuel said, “Overall, US health care expenditures are 2.4 times the average of those of all developed countries ($2759 per person), yet health outcomes for US patients, whether measured by life expectancy, disease-specific mortality rates, or other variables, are unimpressive.”

He said that expensive drugs and treatments that provide only marginal benefits are the largest problems. Fee-for-service payments, physician-directed pharmaceutical marketing, and medical malpractice laws and the resultant defensive medicine encourage overutilization. Direct-to-consumer marketing by pharmaceutical companies also drives up costs.

Ezekiel Emanuel Conflicts

In a 2007 slideshow Conflicts of Interest, Emanuel said that there were conflicts of interest between a physician’s primary responsibilities and a physician’s secondary interests. Emanuel said that while it is difficult to know when conflicts of interest exist, the fact that they do is “the truth”. When there is no doubt of a conflict, the issue is not a mere conflict of interest, but a fraud.

However, industry-sponsored tests are more likely to use double-blind protocols and randomization, and more likely to present study endpoints and mention adverse effects. Also, there is no evidence that patients are harmed by such studies. However, there is evidence that money influences how test results are interpreted. Emanuel mentioned the Selfox study on the use of calcium channel blockers in treating hypertension, in which authors with a financial interest in the results reported much better results than the rest.

Worse yet, test results sponsored by industry are likely to be widely published only if the results are positive. For example, in a Whittington study for data on selective serotonin reuptake inhibitors, negative results were much less likely to be published than positive results. However, in The Obligation to Participate in Biomedical Research the authors Schaefer, Emanuel, and Wertheimer said that people should be encouraged to view participation in biomedical research as a civic obligation, because of the public good that could result.

In a 2017 article Conflict of Interest for Patient-Advocacy Organizations, Emanuel found that financial support of patient-advocacy organizations from drug, device, and biotechnology organizations was widespread. Later that year, he argued in another article Why There are No “Potential” Conflicts of Interest that conflicts of interest exist whether or not bias or harm has actually occurred.

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