"You Brought It Up"

   The doctor, a specialist, is so esteemed, erudite, and learned, therefore busy,  that a prospective patient needs a physician's referral as a first step.  Then the request for appointment is reviewed by a panel of nurses for consideration, and possible acceptance.  Yes, exactly, a "panel of nurses."
    The consult, finally granted, leads to his saying that, contrary to what you may think, the condition is not rare.  The "condition" being diagnosed as a part of a vast spectrum.  His mother has it, he states, has had it for a time.  I ask how she is doing.  "I don't like to talk about it," he says, "but I will if you want me to."
    "Sorry," is all I say, but he goes on to talk about it anyway, some details about both his parents.  He volunteers that if he himself were to seek assisted living, he would consider going to the Midwest, where the costs are much lower.  He mentions Milwaukee, a beautiful city.
     The next day we are in an attorney's office.  She is preparing for her son's wedding in Syracuse.  She will wear navy blue with silver accessories, though her favorite color is lavender, which would clash with the bridesmaid's dresses.
     The last day of the week finds me in an accountant's office.  I need a return appointment, but it will be delayed because his wife is to undergo eye surgery at Ellis Hospital.
    This comprises my entire social interaction for the week, nay, the month, oh, OK, the entire year, to date.

"Ethical and Religious Directives for Catholic Health Care Services"

    "A person has a moral obligation to use ordinary or proportionate means of preserving his or her life.  Proportionate means are those that in the judgment of the patient offer a reasonable hope of benefit and do not entail an excessive burden or impose excessive expense on the family or the community."
   Who writes this stuff?  So a billionaire in mortal physical distress would not have to worry about imposing an EXCESSIVE EXPENSE  on family or community, but the rest of us should take that into consideration, before, say, consuming an inordinate amount of antibiotics.  And who would "the community" be?  Since this was written before the GoFundMe sites, the community would most likely refer to the insurance companies or Medicare.
    I suspect the highly touted Advance Directives and Living Wills, etc. make little or no difference in the long run, except maybe for your choice of donating your body parts. The issuing of such may serve as further justification for the decision-makers.  Legal justification, that is; moral justification has no place in pragmatic statements.
        It's simplistic to define terminology:  if you need to explain what the subjective word "proportionate" means, just use other equally subjective words to define it.  Who can separate the concept of "hope of benefit"  from "reasonable hope of benefit" or determine what amount of expense is "excessive expense"?
   I see that the "judgment of the patient" is the deciding factor.  But then, at this time,  isn't someone else in charge of determining the patient's ability to make a rational judgment?