I'm looking at my driver's license, and down near the bottom edge is the tiny red heart emblem that marks me as an organ donor. It is a measure of how perplexed I am by the fate of Terri Schiavo that I was actually contemplating getting my license renewed two years early so I could delete that little bastard.

I haven't done so, but I may yet. It's not that I'm particularly afraid that someone is going to drug me, rob me of my kidneys, and leave me in a tub full of ice; it's because I recognize that "managed care," more than anything else, means "cost control," and few things cost less than zipping someone into a body bag. And given the fact that there are people who really believe that it's the duty of the elderly to sacrifice themselves rather than become a burden to their families or to the government, I expect that geezers like me will be placed under increasing pressure as time wears on. Used to be, I laughed at this sort of thing, à la Harry Nilsson in "I'd Rather Be Dead"; today I can't work up even the vaguest thin-lipped smile.

"Euthanasia," of course, is a euphemism. I suppose it's a "good death" for someone, though it's difficult to imagine how, except in the most extreme of circumstances, it's good for the recipient. This is the dark underside of the "right to die" movement, a movement I would otherwise support; if you've had enough, you should have the option to opt out of life, and I see nothing particularly wrong with recruiting medical assistance in the matter, assuming that the practitioner in question has balanced hypocrises and Hippocrates. Where I get antsy is when it expands beyond the rarity it ought to be, which it will, and becomes an option that every patient is expected to consider, which is just a matter of time. And if the patient is not able to make this fine judgment call — well, we've already seen what happens when you rely on a single referrer with a conflict of interest.

Right now, I'm leaning toward the approach taken by Lucy Gwin of Topeka, Kansas. In a letter castigating Harper's Magazine for doing a "Death with Dignity" piece, a letter the magazine published in its April 2005 issue, Ms Gwin reveals her own intentions:

I intended to make a living will myself, since I'd rather be dead than brain-damaged, but a drunk driver nailed me first. Neurologists classified my brain damage as severe. For a time I was ... "plugged into a wall like a Mr. Coffee machine." Today my living will, engraved on a dog tag, says, "Spare no expense. Keep me alive." Reading it, one hospital clerk actually gasped, "But that's so selfish!"

The right to die is not about pain or your family's stress; it's about what economists call "a downward pressure on rising costs."

So that's why they call it the "dismal science."

The Vent

  23 March 2005

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