"With respect to the continued skyrocketing of health care costs, Americans need to have a sober, unsentimental discussion related to life...and death. We know that medical treatments that prolong life for what is often a very short time, add enormously to health care costs. I don't have the answers, though I fervently believe the individual should make the "where and when to die" decisions. I don't see America as being ready for this discussion any time soon. Too much influence from the religionists, or perhaps just the unwillingness of too many people to consider their own mortality."

Mr. T.,

I sort of agree with this. I personally as a non-believer in an after life, want to stay as long as I think semi-straight (which may end any day now the way this week is going). I don't think a lot of Americans are very good with death at all. I think it's more the unwillingness to consider their own morality.

A lot of the explosion in health care costs is driven by tests for all, even more than extending life prolongment sorts of procedures. Radiology departments are where the costs really soar--CAT scans, MRI's--surreal in their expense. Radiology far outstrips surgery departments in terms of what health care costs.

Hard to judge where life ends, when treatments should be abandoned. My Mom was an extremely vital and healthy person with a very sharp mind into her early 80's. When she was first diagnosed with cancer, the doctor told her that the toll chemo would take on her wasn't worth it, that she had had a good long life and essentially go home.

She didn't take this very well, just plain wasn't ready for this sort of news. So--I got her a real opinion from Dana Farber here in Boston and she took a reasonable amount of chemo and lived 3 more years where she was very vital and enjoyed the heck out of things (even became the girl singer in a jazz combo after a life of fearing singing in front of people) until the cancer returned and won that go around.

Mortality is a bear, isn't it?

I don't know what's going to happen when the skazillions of folks who are 55 to 65 now are 20 years older than now--how that will change the discussion of mortality. I'm betting though that prolonging life will be insisted upon by that lot.