THE LIMITS OF MEDICAL CARE

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The debate on health care reform ought to make us consider the role and limits of medical care. Legislative initiatives such as the “Death With Dignity’ referendum, which would allow physicians to prescribe lethal doses of drugs to terminally ill patients. In this century, the life expectancy
has more than doubled. Menopause, once a novelty, is now routine. Osteoarthritis was once so rare that those afflicted were respected as esteemed elders; now it is just another chronic, common garden-variety disease of the aging. No one disputes that our health care system should act to prevent disease, or that it should vigorously intervene to return to good health a previously healthy but now sick person. But what of the seriously chronically ill, whose quality of life has deteriorated to the point where it has no meaning to them; when existence is a prolongation of the process of dying? How much control do we as a society want to give to them, their families, their physicians? These are knotty questions. We have to confront them. Most of us can expect to live into old age, only to linger with chronic disabling disease. Our answers will affect us all.

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