Anyone who lives in Washington and has an official position viscerally understands the cost of a lack of privacy. Every dinner - especially ones with a journalist in attendance - is preceded by the mandatory, 'This is off the record.' But everyone also knows, nothing is really 'off the record.

Americans tend to endorse the use of physician-assisted suicide and euthanasia when the question is abstract and hypothetical.

We had a big controversy in the United States when there was a limited number of dialysis machines. In Seattle, they appointed what they called a 'God committee' to choose who should get it, and that committee was eventually abandoned. Society ended up paying the whole bill for dialysis instead of having people make those decisions.

Having been an oncologist and having cared for scores, if not hundreds, of dying patients, when you don't have a treatment that can shrink the tumor and the patient will die, it's a very difficult conversation. It's emotionally draining.

By establishing a social policy that keeps physician-assisted suicide and euthanasia illegal but recognizes exceptions, we would adopt the correct moral view: the onus of proving that everything had been tried and that the motivation and rationale were convincing would rest on those who wanted to end a life.

We all focus on health care and diabetes and heart disease but there's all sorts of things like the simple fact that, you know, heavier people, transportation is more, so there's more spent on gasoline, more on jet fuel, people have had to change the size of doorways, the size of chairs on airplanes and at sports stadiums, so there's a lot of hidden costs as well to the increasing girth of Americans.

Patients who are being kept alive by technology and want to end their lives already have a recognized constitutional right to stop any and all medical interventions, from respirators to antibiotics. They do not need physician-assisted suicide or euthanasia.