01:00 AM EST on Friday, April 1, 2005

THE TRAGEDY at the core of the legal and moral fight over Terri Schiavo, who died yesterday, has put new light on the right-to-die and euthanasia debates.

Euthanasia has been a subject of debate on a number of fronts in recent months. Pope John Paul II's illness has focused attention on his very public suffering, which is being interpreted as setting an example in how to accept the frailties of old age and oncoming death with courage and dignity. Certainly, Catholic and Protestant churches do not condone suicide per se.

In addition, the U.S. Supreme Court in February decided to hear the Bush administration's challenge to Oregon's Death with Dignity Act, which legalizes "active euthanasia." Under that law, a doctor may prescribe life-ending drugs if the patient meets certain criteria and has made the choice to end his or her own life. The act itself is carried out by the patient.

And two films that won Oscars -- Million Dollar Baby and the Spanish The Sea Inside -- address passive euthanasia, which, as in the Schiavo case, involves the removal of equipment to maintain life. In both films, the decision revolves around characters paralyzed from the neck down.

Advocates for the disabled who oppose euthanasia have objected to Million Dollar Baby. And the examples of the pope and the late Christopher Reeve testify to the resilience of people facing death or who have suffered catastrophic injuries.

The Schiavo case is unusual in that her family has been so deeply and publicly divided. Many cases, particularly those involving deformed newborns, are resolved privately, by the family, with its doctors and spiritual advisers.

Mrs. Schiavo's husband, Michael Schiavo, claims that she would never have wanted to live in what doctors called her persistent vegetative state, while her Roman Catholic parents, Robert and Mary Schindler, claim that she had to be kept alive at all costs.

Ms. Schiavo did not leave a living will, which might have resolved the matter from the start. Pro-life activists -- largely from the conservative Christian community, both evangelical-fundamentalist Protestant and Catholic, as well as some Orthodox Jews -- have long waged war on the right to abortion under Roe v. Wade. In this case, they marshaled their forces to argue that life per se, however limited and possibly unwanted, must be honored over euthanasia, however merciful in intention.

The question is whether life per se can be disassociated from quality of life.

Consider, for example, that the so-called golden years are looking less golden than many are willing to admit. The breakdown of the extended family has resulted in many senior citizens' living in assisted-living communities and nursing homes, where they are isolated from the rest of society -- from children, young adults, families, the middle-aged -- to say nothing of the tumble of everyday life. It may be sad to say, but many such places resemble warehouses for the elderly, where many say that they are lonely, bored and frightened.

To be sure, old age for the majority of people with family, friends and community can be as full as any other period of life. It's the final months, or years, when folks sometimes feel forced to enter nursing homes that are an increasing source of concern.

Let's face it: Few of us will die quietly at home. Most of us will die in institutions, possibly suffering from debilitating social isolation, in addition to physical and mental ailments.

Many years ago, I worked part-time as a caretaker in a nursing home in upstate New York. One resident left a lasting impression. When she first moved in she was cheerful and chatty. But every Friday she packed her bags, ready to go home the following day. Every Saturday her family visited, and painfully convinced her that she was not going home. After a while she took to hiding her suitcase. Finally, she ran away, but was brought back.

Then it seemed the penny dropped, and I guess she realized she was never going to live at home again. She "turned her face to the wall." She would not get out of bed to eat or wash, and within a couple of weeks she was dead.

She had apparently made a decision to die, and simply ceased functioning. Would she have wanted to be kept alive? I don't think so. Certainly I think it is fair to argue that she had made a choice, however pathetic and tragic.

Oregon's right-to-die law, which passed in 1997, throws an interesting light on the right-to-die issue. Although the state's residents have twice voted for the law, the Bush administration holds that prescribing drugs to assist suicide is not medically legitimate and that doctors who do so are violating the federal Controlled Substances Act.

The Supreme Court will hear the appeal in October. But in fact, very few -- only 171 Oregon residents out of the many hundreds who have been granted the right to die and the 30,000 who die every year -- have chosen to take advantage of the state's law, which involves strict guidelines. They include painful illness, a life expectancy of six months or less, counseling on alternatives such as pain relief and hospice care, and the consent of two doctors.

As the Baby Boomer generation ages, how many of us will want to spend our final days among strangers in unfamiliar places -- where the days become so uniform that every day seems like Monday?

Rather, will not many prefer to at least have the "option" to die quietly, with self-determination and dignity? (The writer Hunter Thompson, who recently shot himself to death at age 67, may not have died quietly but he did die with self-determination and, arguably, with dignity.) After all, as any adult knows who has lived through the death of someone close, death is, like sex, "what people do."

Certainly, this has been Michael Schiavo's argument: that his wife, Terri, would have preferred to die with dignity rather than be kept alive in a persistent vegetative state.

I know, I know -- as Dylan Thomas wrote, we are not supposed to "go gentle into that good night,/ Old age should burn and rave at close of day;/ Rage, rage against the dying of the light." But surely better, at some point, to accept death and, to paraphrase T. S. Eliot, go out with a bang, not a whimper.

Peter Elsworth is a Journal copy editor.