When we discuss end of life medical care, we have to be careful to recognize that the word “end” has multiple senses. We regularly mean it in the sense of “terminus”, where life reaches its stop, its limit and is no more. but we need to remember that “end” also has the sense of purpose. Is life an end in itself? Is life good in itself, no matter how painful and restricted it is, no matter if a person is utterly demented or comatose? If life is good in itself, an end in itself, then whose good is it? Is it a personal good, a social good, a theological good, a combination of all these?

Of course the question of what life is for, what its end is comes up for us everyday in our living, if we let ourselves arrive in the vicinity of the question “How shall I live?” and dwell there. What gives lives its worth is not the same for all persons. In fact the diversity is staggering. What life is for, what its end is is not the same for one person in different phases of his life. Different people identify themselves differently with different faculties. When persons can not communicate with recognizable lucidity or at all, then we are in the realm of inference about their dispositions. Inference calls for what can be excruciating modesty.

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