An amazing evolution has taken place in this century: medical science has advanced to the degree that now, instead of dying from infection, we are more likely to succumb to chronic disease; the cumulative result of lifestyle, genetics, environment, and time. Innovative technology continues to advance us to a state of expectation that death can be deferred and, in the minds of some, suspended. Death is no longer something we prepare for; instead, it is something we battle to the bitter end. Since approximately 1979, life expectancy has not increased much at all; it remains at about 72 years for men and 78 for women. However, the actual process of dying has become lengthy, complex and, ultimately, expensive.

There have been two unfortunate outgrowths of the technological revolution. One, which transcends all aspects of society, is our expectation -- demand, if you will, of perfection, and our right to compensation if we don't get it. The second was the creation of a medical sub-specialty: defensive medicine, which does not prolong life or improve health but rather increases medical costs by implementing often unnecessary tests and procedures, sustaining life beyond actual living.

Unraveling this tangled web surrounding the insurance, legal and health care system is a daunting task that will take no less than a cultural revolution. We can look to the legal system; though embroiled itself, it has a profound influence on societal trends. Slowly, more people are suing doctors and hospitals for taking the very life-sustaining measures that, in the past, they were sued for not attempting. Perhaps if this trend continues we can begin to do away with the "need" for defensive medicine and, in turn, lower our expectations to a reasonable level. An unfortunate strategy, but one to which people respond.

Better still, as individuals we can be activists for reform and reject the attitude that we are inherently entitled to compensation because of another's failure to meet our expectations. Most importantly, we can begin to look at death for what it is, no matter the cause: a part of life.