I recently celebrated a birthday that officially puts me into the “old man” category. Frankly I’ve experienced a waterfall of emotions, some of which have been expressed on this blog.

I’ve returned to discuss a controversial topic of particular concern to the elderly. I’m not going to regurgitate data relating to the aging of America. Fact is Americans, on average, are getting older each year.

This phenomenon is a testament to superb efforts by doctors and researchers that ultimately enable us to more effectively fight disease. But there are some dark issues to this longevity bonanza.

You’ve heard the expression that most people spend more on medical care in their final years than they do during their early years. Instead of two or five years of intense medical attention, the older generation is now demanding five to ten years of intensive care.

The resulting impact on America is higher medical costs, greater insurance premiums and horrendous stress on our national health care infrastructure. If the country’s average life span increases every couple years, you can only imagine what will happen to medical costs (Medicare) and the stress on our hospitals and doctors. Wise politicians are already preparing their constituencies for some grim actions that will likely be necessary to avoid a more serious impact on our country’s financial resources.

Having a Medicare age of 65, when our average life expectancy is 70 is sensible. But does it make sense if our average life expectancy is greater than 80, and when most people work far beyond 65? The most obvious need is to delay Medicare a year or two or three, in the near future. Since this is one of the third rails of politics, making a change in Medicare age will be a monstrous undertaking.

But, what about our life styles? Is sitting in front of a TV a good life. Our nation needs to provide ways to keep our elderly intellectually active. It will necessitate great social change, including much more involvement of our adult children.

Having pains and increasingly more medical problems is the life the elderly face. Theoretically it’s better than the alternative. But, is it really? It would be interesting to measure the amount of pain and suffering that is acceptable to people of advanced age. To what degree will a person subject his or her self to pain to stay alive another year or two? Before you have a brush with significant discomfit, it’s natural to think you would always choose life. The opioid epidemic tells us otherwise. Americans take pills to avoid pain at an extremely high rate. In fact, the rate is so high that too many suffers become addicted and die from overdoses.

As a newly minted septuagenarian, I wake up every morning and stretch out all my aches and pain. They are a result of my age in conjunctions with playing contact sports when I was young, along with golf and skiing these days. At times the pain is significant, and I’m in the gym every day.

Others who are my age, more sedentary and suffering from debilitating issues such as arthritis have a very difficult time walking and getting through the day. These people are prime targets for opioid overuse.

The time may come when a serious ailment is too much to bear, or an amalgamation of pain is hard to live with. The choices are: 1. Suffer, 2. Take pain relievers such as opioids, 3. Commit suicide. There are no easy answers.

Let’s focus on the latter- euthanasia, a genteel way to describe ending one’s life. When we think about suicide, too often it results in thoughts about shooting or hanging oneself. But in reality many people move on to the afterlife in a relatively peaceful way in hospice, or with palliative care.

It’s stunning that so many are not in favor of a quick end to a suffering person’s life, yet, for years hospices have deprived individuals of food and water over the course of a few days to hasten death. Is spite of what many defenders say, palliative care is euthanasia by any other name. Similarly “pulling the plug” on life support is not considered murder, but it is an overt act against another human that ends their life.

There are a number of states that have approved euthanasia, and more should be coming around to the same decision over time. We deal with sick animals in a civilized manner by ending their lives to avoid suffering. Why don’t humans deserve the same consideration?

Like any situation involving life and death, it’s a complicated matter to deal with. For one thing euthanasia works best when the sufferer makes the final decision, beforehand in a living will, or on the spot if they are lucid. If third parties become involved the process can get messy. Consider people in a coma for a long period of time, whose relatives can’t find consensus about whether to pull the plug.

Euthanasia is not something available for convenience. Some families are too anxious to end a life if the person is difficult to deal with or using too many resources. Then again financial concerns can be a huge issue for a family that cannot afford intensive care for an extended time. The point is a death decision must be made with great care.

And finally there are religious strictures and busy bodies, who are not shy about sticking their noses in other people’s business. Euthanasia is a family issue. Government should provide guidelines and holy men should become involved only by invitation.

Taking one’s life is not a sin, should not be crime and should be a socially acceptable alternative for people in severe pain and suffering, mental and physical. I hope our politicians recognize this and make euthanasia more accessible.