Dudley Clendinen has a great essay in last Sunday's New York Times about living with ALS. He continues to have a valuable life. But, as his condition deteriorates, Clendinen does not plan to use all available medical technology to prolong his biological life as long as possible. He explains that would just leave him "a conscious but motionless, mute, withered, incontinent mummy of my former self." Instead, Clendinen explains that "when I can’t tie my bow tie, tell a funny story, walk my dog, talk with Whitney, kiss someone special, or tap out lines like this — I’ll know that Life is over. It’s time to be gone.”
Yesterday, David Brooks commended Clendinen for the way he defines what life is: "Life is not just breathing and existing as a self-enclosed skin bag. It’s doing the activities with others you were put on earth to do.” Consistent survey results show that a majority of Americans share this definition of life. Unfortunately, many of these individuals do not get informed consent adequate to assure that they receive treatment consistent with their definition of life.
What about those Americans who do not share Clendinen’s definition of life? Increasingly, we are likely to see less public and private coverage for treatment that does not further Clendinen’s definition of life. (It is, as Schneiderman & Jecker show, a defensible definition.) And we are likely to see fewer physicians providing aggressive medicine that does not further Clendinen’s definition of life. In short, Clendinen’s chosen path, already the one desired by most Americans, will soon become the only one available.
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