CONSIDER ABBY BERTRAND, a retired music professor recently diagnosed with a disease whose prognosis involves dementia and death. Still lucid and mentally lively, she looks into the bioethics literature to find out whether bioethicists have written anything helpful about her plight.

She finds out that many bioethicists are eager for her to be able to get help killing herself if she wants to. Some are eager for her to kill herself whether she wants to or not. John Hardwig of the University of Tennessee says she has a duty to kill herself rather than become a burden to her family if the burden would be unacceptable to them. Dennis R. Cooley of North Dakota State University says she has a duty to kill herself rather than lose her human dignity by becoming demented.

She also finds out that many bioethicists oppose suicide but still want her not to live “too long.” Daniel Callahan, co-founder of the Hastings Center, arguably America’s most influential bioethics think tank, notes approvingly that all-out life-prolonging medical treatment for the dying is “universally decried these days.” Bioethicists frequently lament that America’s old and ill are using resources that could go toward more important American needs or toward basic health care in the Third World.

Abby feels unwelcome in the world of bioethicists. She likes being alive, and her religious beliefs are too hazy for her to have much confidence in an afterlife. So she wants to live on Earth as long as possible. She wonders whether many of those who decry all-out life-prolonging medical treatment for the dying are themselves dying.

She wonders about other things as well. Why shouldn’t a woman who took care of three children expect reciprocation rather than kill herself to avoid burdening them? As for human dignity, does bioethicists’ intellectual nature incline them to disdain the cognitively impaired just as Abby’s gymnast neighbor disdains the clumsy? Ronald Dworkin of New York University belittles what he calls “the meager childish pleasures” available to the severely demented. Abby’s own grandmother had dementia, but even when dying, enjoyed sitting in the sunlight and listening to music. Abby has always enjoyed these pastimes, too. Isn’t this sort of enjoyable life worth prolonging?

When it comes to other, supposedly more important, needs, Abby wonders why America’s most vulnerable citizens should make the sacrifices necessary to free up funds. Why not instead increase taxes on the rich, reduce military spending and give endangered people priority over endangered sea turtles and the like?

Abby realizes that philosophers have a history of putting forth outlandish views without expecting anyone to act on them. She recalls the philosophy course she took in college, which included arguments that you cannot walk across a room or know there are minds other than your own. But she learns that bioethicists pride themselves on not being ivory-tower types. They often serve on hospital ethics committees that advise on practical matters of patient care.

Having read about advance directives, Abby is not surprised when her doctor gives her a copy of the Rhode Island Durable Power of Attorney for Health Care. He urges her to fill it out to indicate what sort of health care she should get when she can no longer make decisions about such care. The page headed “Commonly Used Life-Support Measures” says, “For the dying patient, however, mechanical ventilation often merely prolongs the dying process until some other body system fails.”

“Would they say that to a young diabetic about insulin?” Abby asks.

“Excuse me?”

“Well, insulin doesn’t cure diabetes. It merely keeps a diabetic alive until some other body system fails.”

“That’s different. A young diabetic can have a long, rewarding life ahead of him or her.”

“A dying patient can have a short, rewarding life ahead. Why doesn’t the statement say, ‘Mechanical ventilation won’t cure you any more than insulin will cure a diabetic, but it will give you extra time you might enjoy’? It’s slanted to get terminal patients to bow out quickly.”

“I’m sorry you feel that way.”

And I’m sorry you feel that way, you and all the bioethicists, Abby imagines replying.

Actually, she has read enough to know that it is not all the bioethicists. Some are on her side. They face an uphill road. Abby and her doctor are imaginary, but the Rhode Island Durable Power of Attorney for Health Care and the bioethicists this column mentions are real, as are the direct and indirect quotations from them.

How does that make you feel about your future?

Felicia Nimue Ackerman, a monthly contributor, is a professor of philosophy at Brown University.