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I skimmed Ezekiel Emmanuels’s article and, at age 60, pretty much agree with his thinking. I’ll probably change my mind a bit if I get to 70 with no serious health issues. But, if I had severe Alzheimers deterioration or a profound stroke, I would not want anything other palliative medical care. I have experienced such with family members, and am fairly sure that my view wouldn’t change on that part anyway.

But what I think should not dictate the medical services available to others. This is a uniquely personal decision. Each individual should make his decisions in view of his own values (which include his own financial resources) and in consultation with his family members, his medical providers, and his religious counselors. (The use of “his” is intended, but it includes women as this singular possessive pronoun in its neuter form did before the English language changed in the 70s to accommodate feminist complaints. “Their” is a plural possessive pronoun, and is inappropriate here because the decision is so uniquely personal.)

I see nothing wrong with Emmanuel laying out the reasoning for his end of life decisions. However, no doubt about it, Emmanuel is arguing that this should be public policy. If the state is to assume the role of health care provider, such a public policy is inevitable. Bureaucrats must make decisions that are to be applied uniformly for all covered persons (with a few exceptions for the ruling elite, of course). By necessity, those decisions must reflect a veterinary model for health care of a herd rather than the old-fashioned model that was based on the patient’s choices.