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possible, immortal. Our crusaders, the physicians, arm themselves with shiny modern machinery and powerful drugs to repel the enemy for as long as possible. Meanwhile, we remove the dying from the flow of everyday life and confine them to institutions. As recently as 50 years ago, the majority of people died at home. Today, 80 percent end their lives in hospitals and clinical care settings. And according to an important 1997 study on death and dying led by Dr. Joanne Lynn, director of the Center to Improve Care of the Dying at George Washington University School of Medicine in Washington, D.C., (published in Annals of Internal Medicine, January 1997), most of those people end their days in pain, breathlessness, depression, and confusion. Many patients are subjected to at least one form of "heroic" treatment before they die--cardiopulmonary resuscitation, or attachment to a respirator or a feeding tube--even though fully 59 percent of the patients in the study said they wanted comfort care rather than aggressive treatment in their final days of life.

As the first study to have been carried out on dying hospital patients in almost a century, Lynn's important research highlights two critical factors. First, we as a society have turned our back on death for too long. "Our cultural inclination," Lynn says, "is to disavow dying." Second, the study illuminates how stubborn physicians are in their determination to keep death at bay--even when the patients themselves make it clear that they don't want life-prolonging procedures.

Consequently, it is not surprising that so many of us fear being rushed into an intensive care ward, placed on life-support equipment, and made to linger in a state of semiexistence against our will. This particular fear seems to have grown in direct proportion to our physicians' abilities to perform these life-prolonging feats. The very measures that we once viewed as miracles of modern medicine can now be seen in a...