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CAPITAL CULTURE: Another Emanuel in the spotlight

His brother Rahm is one of the most influential men in U.S. politics, the right-hand man to President Barack Obama. The other, Ari, is one of the very top power players in Hollywood.
/ Source: The Associated Press

His brother Rahm is one of the most influential men in U.S. politics, the right-hand man to President Barack Obama. The other, Ari, is one of the very top power players in Hollywood.

And Ezekiel Emanuel?

He's the REALLY accomplished one, some say.

One of the nation's most prominent bioethicists, Ezekiel Emanuel has a master's degree in biochemistry from Oxford. A medical degree and a Ph.D. in political philosophy from Harvard. He's written or co-written seven books, won numerous awards, and heads the clinical bioethics department at the National Institutes of Health. And he's currently on detail to the White House, as a health policy adviser at the Office of Management and Budget.

Such accomplishments might normally make one the family star. But in the Emanuel clan, which features one current chief of staff to the president (that would be Rahm) and a mogul who inspired the Jeremy Piven character in HBO's "Entourage" (that would be Ari), he's naturally been a bit overshadowed.

Until the last few weeks, that is.

The sometimes ugly health care debate has dragged Ezekiel Emanuel very reluctantly into the spotlight, as opponents of Obama's proposed reform have seized on snippets of his past writings to bolster their charge that he and the administration advocate a system where bureaucrats — on what former Gov. Sarah Palin has famously called "death panels" — would play God, ruling on whether ailing Grandma deserves medical care.

The accusations have been widely debunked as distortions of Emanuel's and the administration's views. Still, they persist, leaving Emanuel both stunned and hurt.

"I'm completely dumbfounded," he said in a telephone interview last week. "I've been in academic disputes before, but I never thought I'd be disparaged on Sunday morning talk shows and in the papers, being distorted in ways that can only be described as willful and intentional."

The irony, he says, is that he's long been a vocal opponent of euthanasia and physician-assisted suicide. What he does advocate are living wills, and voluntary counseling sessions that address end-of-life issues — both as a means to improve end-of-life care.

A fellow bioethicist says Palin and others couldn't have picked a less appropriate target.

"If anything, Zeke has always gone to the other extreme, being very aggressive in trying to help people stay alive," says George Annas, a professor of health law and bioethics at the Boston University School of Public Health. "This has been totally insane."

Emanuel, an oncologist by specialty, says he began focusing in the earliest stages of his career on trying to improve care for the dying. "Almost no one was doing this," he says. "I was told at medical school that this would be a quick end to my career."

"But I worked pretty hard and against the odds to improve end-of-life care," he says. "And so to have that record and that work completely perverted — it's pretty shocking, and it's also very, very hurtful."

Emanuel fully realizes he's being targeted because "I happen to be my brother's brother." Also, he says, he's got an extremely long paper trail. "So I'm a convenient target," he says.

Emanuel and his brothers grew up in Wilmette, Ill. (a sister came later, when the boys were teenagers). Amazingly, Emanuel says, Rahm was the calmest of the boys — which seems rather stunning to those who've heard about "Rahmbo" sending a dead fish to a Democratic pollster he was angry with. Or stabbing a restaurant table with a dinner knife and shouting "Dead!" as he rattled off names of Democrats he considered disloyal.

"Rahm was the peacemaker, the mediator between myself and Ari," Ezekiel says. One gets the sense that the battles were intense.

Although he describes himself as "the goody-goody of the family," the three brothers share a brash nature, Ezekiel says: "No one would describe me as reserved." And a healthy self-regard: "I'm not an obscure bioethicist." But they share much more than that, he adds.

"We are pretty resilient," he says. "We've been knocked down a lot and gotten up. We're all high-energy. We've had elements of leadership qualities, and we have the ability to have a strategic overall vision and understand what's technically needed to get there."

While Rahm is almost always in the spotlight, Ari was front-page news this spring when his Endeavor talent agency merged with the William Morris Agency, leaving him at the top of a huge new agency — a "superagent," as he's usually called. And as "Entourage" viewers know, Ari Gold doesn't get where he is by being a softie.

"However you look at it, my two brothers are incredibly influential people in American society," Ezekiel says — "way more influential than a computer-pecking bioethicist."

What brought this computer-pecking bioethicist's name to the fore was a provision, once in the House version of health care legislation, that would allow Medicare funds to be used for end-of-life counseling, if a patient wants it. As the debate swirled uglier, opponents seized on Emmanuel's writings.

One was New York's former lieutenant governor, Betsy McCaughey, who in a July opinion piece in the New York Post summed up Emanuel's views as: "Don't give much care to a grandmother with Parkinson's or a child with cerebral palsy."

Then Palin cited Emanuel on her Facebook page, charging that his views put people like her son, Trig, who has Down syndrome, in danger.

These and other critics have cited two Emanuel articles. In one, written in 1996, he says he was merely analyzing different ethical philosophies, as academics are wont to do, and not advocating. In another, earlier this year in the medical journal Lancet, he and his co-authors discussed how to make difficult choices when resources are scarce, such as organs for transplant.

Such decisions, Emanuel says, are made in the medical community every day: Witness the recent talk about who should get H1N1 vaccine first.

Emanuel is blunt about his critics' attacks.

The "death panel" idea is "an outright lie, a complete fabrication," he says. "And the paradox, the hypocrisy, the contradiction is that many of the people who are attacking me now supported living wills and consultations with doctors about end-of-life care, before they became against it for political reasons."

Emanuel says he has no idea whether his unwelcome role in the current uproar is on the way toward petering out. It helps, he says, that he has no TV at home — despite being the brother of a top Hollywood agent.

So has this been his proverbial 15 minutes of fame?

"I sure hope not," he says. "Because it feels more like 15 minutes of attack."