goesonitiswithinnarrowerandnarrowerconfines.A
fewconclusionsbecomeclearwhenweunderstandthis:
thatourmostcruelfailureinhowwetreatthesickand
the aged is the failure to recognize that they have
priorities beyond merely being safe and living longer;
that the chance to shape one’s story is essential to
sustainingmeaninginlife;thatwehavetheopportunity
to refashion our institutions, our culture, and our
conversationsinwaysthattransformthepossibilitiesfor
the last chapters of everyone’s lives.
Inevitably, the question arises of how far those
possibilitiesshouldextendattheveryend—whetherthe
logic of sustaining people’s autonomy and control
requires helping them to accelerate their own demise
when theywishto. “Assistedsuicide” has becomethe
term of art, though advocates prefer the euphemism
“deathwithdignity.”Weclearlyalreadyrecognizesome
formofthisrightwhenweallowpeopletorefusefoodor
water or medications and treatments, even when the
momentumofmedicinefightsagainstit.Weacceleratea
person’sdemiseeverytimeweremovesomeonefroman
artificial respirator or artificial feeding. After some
resistance,cardiologistsnowacceptthatpatientshavethe
righttohavetheirdoctorsturnofftheirpacemaker—the
artificialpacingoftheirheart—iftheywantit.Wealso
recognizethenecessityofallowingdosesofnarcoticsand
sedatives thatreduce painand discomforteven ifthey
mayknowingly speeddeath.Allproponents seekisthe
abilityforsufferingpeopletoobtainaprescriptionforthe
same kind of medications, only this time to let them
hasten the timing of their death. We are running up
against the difficulty of maintaining a coherent