Ethics? What is that ?

A few days ago I was at a dinner party thrown in my honor by some of my long term associates. All of them had done well rising to great heights in their chosen professions. Many had retired and formed their own companies, others had become consultants to rapidly rising business houses seeking to enter the complex area of oil and gas exploration, but all had done well. What struck me during our discussions was the fact that almost no one had any compunctions about working for companies who were in direct conflict with a company they had loved and served for over three decades. While they mourned the gradual decline of their old company that had once bestridden the country, but was now beset with poor leadership and worse decision making, embroiled in one conflict or the other and struggling against the new upstarts, they felt no great urge to return and help their erstwhile colleagues. They had become onlookers - actually they had become silent spectators who applauded and supported the upstarts! That, I was told, was the way of the world.


But perhaps more troubling was the blinkered view of the tactics that they were, tacitly or explicitly, forced to collude in to help the new companies. Many of these upstart companies, though not all, used shady means and corrupt means to attain their ends. Those who were consultants felt that it was not in their charter to blow the whistle, others directly employed defended themselves with the old but discredited view that they were simply following orders.


After all "Just Following Orders" is a justification for morally questionable actions that many  invoke when questioned about the rightness or necessity of such actions. This justification holds that the (bulk of the) responsibility for such actions falls upon those who make such decisions and give such orders within any hierarchy; by extension, those who obey and act upon such orders cannot be held accountable for their actions. 


The ethics dilemmas typical engineers face in their careers are probably not the stuff that sells newspapers. While there have been some widely published accounts of bribery, disregard for safety, and deceit, an engineer is more likely to deal with conflicts of interest, or confidentiality concerns. Engineers can deal with the black and white issues pretty easily but there are gray areas where two ethical principals conflict with each other. For example, the duty to protect the public health and safety sometimes conflicts with the obligation to 
maintain confidential information for a client. Or the desire to curry political favours sometimes leads to make claims about reserves that they know are dubious at best. Or they avert their eyes when their company indulges in corrupt practices to obtain a contract.


Are there no codes of ethics for engineers similar to other professions the most famous
being the Hippocratic Oath that all graduating medical students take?


The Hippocratic Oath in its earliest form is rather simple: "I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism. I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. I will not be ashamed to say "I know not", nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.I swear to fulfill, to the best of my ability and judgment, this covenant: I will prevent disease whenever I can, for prevention is preferable to cure. I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.I will remember that I remain a member of society with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm. If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.".


Perhaps it is time for engineers to develop their own oath or a code of ethics which is as simple and as direct as the one above? Why should not all engineering courses insist on a program on engineering ethics?

PS I found out that many professional societies of engineers do have a code of ethics- most are about five pages long- but none have the moral force of the Hippocratic oath.And none of our IIT's teach about ethics in their four year programs.

In the face of grief

Many are the times that we sit in the face of grief, tongue tied and at a loss for words. When a tragedy strikes a close friend or relative of the family, our first instinct is to rush to them to offer solace and support. But once we are in their presence, we rarely know what to say or how to articulate the deep love and grief we want to share. So we sit often facing them in silent contemplation of the loss we have suffered and through some osmosis convey what is in our hearts.

I thought of this when in recent times I faced these truths and reflected on what were the different ways the face of grief emerged.

A few years ago we were in Goa and heard that our friend of many years was ailing. So we hired a car and set off to see him in his far off casa. He was asleep so we made small talk with his wife. But when we were about to leave, she insisted that he would never forgive her if he did not come out to greet us. So he was woken and soon emerged. We were shocked to see him- his face had wizened, his gait was slow and uncertain and he looked really frail - a shadow of the energetic lively presence that we had been accustomed to. Of course, that had been at least three decades ago but still the mental image we had of him had not changed. For a while we were at a loss to speak. Perhaps sensing our surprise, he started to talk in a rather strong voice of our past associations, of how he had sat in a helicopter with me when I had taken him and other journalists to see Bombay High offshore installations, how he remembered me dealing with official files during the journey using a golden pen,how he drew cartoons for my wifes magazine. And his memories put us at ease and we spent a lovely lively afternoon with him sipping tea and exchanging remniscienes. He died soon thereafter but our memories of him now mingle with his early days and his last years.

In another case, we had gone to see a friend who had lost his wife of three decades uncertain how we would offer him consolation. But found that he wanted to share his memories and really wanted us to only listen to him talk about her last days and the courage and dignity with which she had faced her pernicious disease and its aftermath. And that is all we did. 


When faced with a grieving person it is often hard to know what you should or should not say to them. You want them to know that it will be okay and eventually get easier. You also want to express your condolences and let them know that you are there for them. Grief is a very personal, raw and vulnerable period of one's life. There are things that you might mean well by saying, but they do not want to hear. People who are in a state of grief are very emotionally vulnerable and trying to work through feelings that they never thought they would be faced with.  

I find that in the face of grief all you really need to do is to be present and to listen to their story if they so want to speak. But if they are silent, you should speak of the happier times that you shared with them. Saying "I am so sorry" or "I am here for you" are the best condolences that you can give. This does not insinuate that you know how they feel, or that things will get better. You are simply offering to be there for them and that is the most important thing.

Pioneers of offshore technology in India

In the last five decades, India has made tremendous economic progress. One of the key pillars of its success has been its ability to harness the power of science and technology for development. In many key areas it has found men of vision and daring who have absorbed the latest technologies of the day and have been able to mobilize the brightest minds in the country to lay the foundations of a modern India. The key to this success has been scientists and technologists with a keen vision and deep commitment, supported by a forward looking political leadership of the day, a bureaucracy in tune with the needs of the country and a population willing to embrace the latest that modern science had to offer in its search for rapid economic development. Thus in the fifties came the dam builders like A N Khosla, followed by Homi Bhabha who harnessed the power of the atom and built the country’s nuclear capability through the Atomic Energy Commission. The country produced Vikram Sarabhai who led the county into the space era, V Krishnamurthy who built the heavy electrical capacity, the Tatas who laid the foundation of modern India’ s steel industry, SMPatil who developed an indigenous capacity for machine tools, MS Swaminathan who developed the seeds that led to the green revolution, MS Pathak who built the engineering consulting capability. These were the true founders of modern India on the basis of which the economic progress of the country was built.

Another of these areas was offshore technology. The creation of an indigenous capability and capacity in offshore technology laid the foundation of an oil industry that by the mid eighties was able to provide self sufficiency to the extent of 70%, created a completely new industry, mobilized the best of scientists and technologists and laid the foundation for both rapid economic growth and a new infrastructure for development.

In 1970, India had no capability for offshore engineering, it had no fabrication yards for building offshore oil platforms, there were no submarine pipelines to carry oil and gas from offshore platforms, indeed there were no offshore process platforms or terminals. No offshore drilling rigs patrolled the oceans, there were neither supply vessels nor fire fighting ships. In short there was nothing.

Yet by 1985- in just fifteen years, India had over 50 offshore platform off the coast of Bombay. It had discovered its largest oil and gas fields offshore and able to develop them within a short space of a decade. It had designed and built not only offshore well platforms, but also the most complicated and complex of process platforms that were able to separate oil and gas offshore and to transmit them to the shore. It had built a large number of major and minor submarine pipelines. It had developed an indigenous capability to design all offshore installations, which by 1985 was responsible for almost 80% of all offshore work. India had been able to convert three shipyards to build the latest offshore platforms and pipelines. It had over 20 offshore drilling rigs operating offshore, many of them owned and operated by Indians. These structures, most designed, fabricated and constructed indigenously enabled oil and gas production of over half a million barrels of oil and by the mid eighties and set the country towards self sufficiency.

This book, "Pioneers of offshore technology", is an attempt to chronicle the story of this latest effort to mobilize science and technology for economic development. It lays out for the reader the strategies and the driving forces that made this success possible and the young pioneers who made it possible. Not only did these young pioneers build and create the offshore technology in India, they also laid the foundation of a completely new industry, they went on to make major contributions to the international oil industry as well. Many of them went on to become chairman of international companies , create an offshore supply services company , design companies, and others became key players in offshore oil and gas companies in Korea, U.S, Australia, Indonesia, Singapore.

The book presents their stories and it is a chapter in our history of science and technology that the nation should be truly proud of.

The richest Indian in America and the energy drink

Manoj Bhargava claims to be the richest Indian in America. And how did he become so rich? By selling a 5 hour energy drink!

Bhargava was born in India in the prosperous northern city of Lucknow. His parents were well-off, with a villa surrounded by lush, award-winning gardens. They left for America in 1967, so his academic publisher father could get a Ph.D. at Wharton. The family landed hard in West Philadelphia in a third-floor, $80-a-month walk-up with threadbare carpets on seedy 47th Street. They went from having servants in India to splitting one Coca-Cola four ways as a treat.

Teenaged Bhargava excelled at math. “It’s like in Good Will Hunting,” he says, raising a hand to mime Matt Damon’s chalkboard scrawl of algebraic equations in the film. “You see stuff or you don’t. I just see it.” He had no tuition money, but connived his way into interviews at competitive Philadelphia schools, offering to take math tests to prove himself.


Bhargava says he spent his 20s traveling between monasteries owned and tended by an ashram called Hanslok. He and his fellow disciples weren’t monks, exactly. “It’s the closest Western word,” he says. “We didn’t have bowler haircuts or robes or bells.” It was more like a commune, he says, but without the drugs. He did his share of chores, helped run a printing press and worked construction for the ashram. Bhargava claims he spent those 12 years trying to master one technique: the stilling of the mind, often through meditation. He still considers himself a member of the Hanslok order and spends an hour a day in his Farmington Hills basement in contemplative silence. But whatever it is, it has made him a billionaire through a drink that most people have not even heard of but which truck drivers in the US swear by!

And what is in that drink: 5-Hour Energy’s ubiquitous bottle is no beauty, with its shrink wrap and crudely silhouetted running man (his name is Steve, by the way). Inside the bottle: 4 calories, zero sugar, “a blend of B-vitamins, amino acids and nutrients,” and “about as much caffeine as a cup of premium coffee,” according to 5-Hour’s website. A 2010 test by independent reviewer ConsumerLab.com found vitamin levels thousands of times higher than recommended daily allowances and 207mg of caffeine—a massive amount per ounce, but less than the 260mg in a Starbucks tall coffee.

The exact formula remains a secret. And so it should. Otherwise Manoj would not be the richest Indian in the US, would he?

Obama explained

As Barack Obama contends for a second term in office, two conflicting narratives of his presidency have emerged. Is he a skillful political player and policy visionary—a chess master who always sees several moves ahead of his opponents (and of the punditocracy)? Or is he politically clumsy and out of his depth—a pawn overwhelmed by events, at the mercy of a second-rate staff and of the Republicans?


James Fallows has a long piece on Obama  where he attempts to unravel the mystery of Obama.


"What I’ve concluded now is that Obama has shown the main trait we can hope for in a president—an ability to grow and adapt—and that the reason to oppose his reelection would be disagreement with his goals, not that he proved unable to rise to the job. As time has gone on, he has given increasing evidence that the skills he displayed in the campaign were not purely a fluke." concludes Fallows.


“Three of the most important things he has done are hardest to appreciate,” says Tom Daschle, the former Senate majority leader and an early supporter of Obama’s presidential campaign.


The first is a negative accomplishment: avoiding an economic catastrophe even worse than the one the United States and the world have been through.


 The second is what Daschle called “the dramatic improvement in the American image abroad.” The daily reports about American problems around the world, the crises in U.S. relations with Pakistan and a few other countries, the ongoing worldwide bull session about whether the U.S. is “in decline”—all of these things mask the broad and dramatic improvement in America’s “soft power” and international standing during Obama’s time.


 And finally, according to Daschle, the health-care bill that passed so narrowly and is so controversial will, especially if Obama is reelected, rank with Medicare in the list of legislative and social achievements by Democratic presidents.


There are many areas where Obama has shown mastery of the job. In foreign policy, where a president can carry out his own strategy, he has shown that he actually has a strategy to execute. And in management of the domestic economy, he has shown increasing command of the tools of office. In political combat, his long term strategy will eventually lead to his reelection.


Chess master or pawn? The evidence is clear.


Andrew Sullivan adds his take on the long term strategy underlying Obama's approach to governing:

On the domestic front: " A depression was averted. The bail-out of the auto industry was—amazingly—successful. Even the bank bailouts have been repaid to a great extent by a recovering banking sector. The Iraq War—the issue that made Obama the nominee—has been ended on time and, vitally, with no troops left behind. Defense is being cut steadily, even as Obama has moved his own party away from a Pelosi-style reflexive defense of all federal entitlements. Under Obama, support for marriage equality and marijuana legalization has crested to record levels. Under Obama, a crucial state, New York, made marriage equality for gays an irreversible fact of American life. Gays now openly serve in the military, and the Defense of Marriage Act is dying in the courts, undefended by the Obama Justice Department. Vast government money has been poured into noncarbon energy investments, via the stimulus. Fuel-emission standards have been drastically increased. Torture was ended. Two moderately liberal women replaced men on the Supreme Court. Oh, yes, and the liberal holy grail that eluded Johnson and Carter and Clinton, nearly universal health care, has been set into law. Politifact recently noted that of 508 specific promises, a third had been fulfilled and only two have not had some action taken on them. To have done all this while simultaneously battling an economic hurricane makes Obama about as honest a follow-through artist as anyone can expect from a politician."

"On foreign policy, the right-wing critiques have been the most unhinged. Romney accuses the president of apologizing for America, and others all but accuse him of treason and appeasement. Instead, Obama reversed Bush’s policy of ignoring Osama bin Laden, immediately setting a course that eventually led to his capture and death. And when the moment for decision came, the president overruled both his secretary of state and vice president in ordering the riskiest—but most ambitious—plan on the table. He even personally ordered the extra helicopters that saved the mission. It was a triumph, not only in killing America’s primary global enemy, but in getting a massive trove of intelligence to undermine al Qaeda even further. If George Bush had taken out bin Laden, wiped out al Qaeda’s leadership, and gathered a treasure trove of real intelligence by a daring raid, he’d be on Mount Rushmore by now. But where Bush talked tough and acted counterproductively, Obama has simply, quietly, relentlessly decimated our real enemies, while winning the broader propaganda war. Since he took office, al Qaeda’s popularity in the Muslim world has plummeted. Obama’s foreign policy, like Dwight Eisenhower’s or George H.W. Bush’s, eschews short-term political hits for long-term strategic advantage. It is forged by someone interested in advancing American interests—not asserting an ideology and enforcing it regardless of the consequences by force of arms."

What neither the liberals nor the conservatives have never understood about Obama is that he practices a show-don’t-tell, long-game form of domestic politics. What matters to him is what he can get done, not what he can immediately take credit for.


And the fervent hope is that the electorate will understand this come November.

A fresh view on India's experiment in democracy

Ramchandra Guha has a fresh take on India's experiment with democracy.

According to Guha " Democracy and nationhood in India now face six complex challenges."

The first is that in three states of the Union, large sections of the population want independence. In Nagaland, an uneasy ceasefire prevails between secessionists and the government; in the valley of Kashmir, peace is erratically secured by a massive army presence; and in Manipur, rival groups of insurgents fight with each other and with the government.

Second, the territorial unity of India is further challenged by a Maoist insurgency in the centre and east. Maoists have dug deep roots among the tribal communities of the heartland. The opening of the Indian economy has had benign outcomes in cities such as Bangalore and Hyderabad, where the presence of an educated workforce allows for the export of high-end products such as software. In other places, globalisation has meant the increasing exploitation of unprocessed raw materials. In states such as Orissa, Jharkhand and Chhattisgarh, mining companies have dispossessed tribals of the land they owned and cultivated, leading sometimes to their recruitment by the Maoists.

Third, the challenge from religious fundamentalism is receding but by no means vanquished. In 1984, several thousand Sikhs were slaughtered in northern India after the assassination of Prime Minister Indira Gandhi by her Sikh bodyguards; in 2002, a comparable number of Muslims were killed by Hindus in Gujarat. Those pogroms bookended two decades of almost continuous religious conflict, fuelled principally by right-wing Hindus and by Islamic fundamentalists based in Pakistan. But since 2002, there has been no serious Hindu-Muslim riot. (The jihadis who attacked Mumbai in 2008 failed to spark retributive violence against Muslims.) The middle class is no longer so enamoured of a Hindu theocratic state, and Indian Muslims are mostly focused on education and job security. What prevails, however, is a sullen peace rather than an even-tempered tranquillity, in which the secular ideals of the constitution are not always reflected in practice.

The corrosion of public institutions is the fourth problem. This has several dimensions, including the conversion of political parties into family firms; the politicisation of the police and bureaucracy, with appointments dependent on patronage rather than competence; billion-dollar corruption scandals at high levels of government, with the state handing over natural resources and other assets to particular capitalists; and everyday corruption faced by ordinary citizens, such as bribes paid to set up electricity connections or admit children to school.

Fifth, massive environmental degradation promotes discord and inequality in the present, while jeopardising economic growth in the future. The depletion of groundwater aquifers, chemical contamination of soil, and the decimation of forests and biodiversity leads to resource scarcity and conflict between different users. The environmental costs of economic growth fall disproportionately on the rural poor, who suffer the most from land grabs, deforestation, and soil and water pollution.

Finally, there are pervasive and growing economic inequalities. Mukesh Ambani, India’s richest man, is worth over $20bn. His new home in Mumbai is 27 storeys high and measures 400,000 square feet. At the same time, 60 per cent of the city’s population live in crowded slums, five or six to a room, with no running water or sanitation. These disparities extend beyond the city to the whole of India. The super-rich exercise massive influence over politicians of all parties, with policies and laws framed or distorted to suit their interests. The rise of left-wing extremism, and the growth in corruption and environmental degradation are in good part a consequence of this ever-closer nexus between politicians and businessmen."

"One can think of a democracy as a stool with three legs" continues Guha, " the state, the private sector, and civil society. The state is required to frame suitable laws and policies, maintain order, prevent discrimination against individuals or communities, hold regular elections to allow changes of parties and leaders, and be ready to repel attacks from other nations or home-grown insurgents. The private sector’s task is, by one definition, merely to generate goods and services by the most efficient means possible; in a more capacious understanding, to make and sell products and promote philanthropic activity. The role of civil society is to keep both state and private sector on their toes, by highlighting perversions of the law and on the other hand, to foster community organisations that work towards equal access to, among other things, education, health and a clean environment."

The stability of any democracy is dependent on the proper functioning of these three sectors. If one or other sector is negligent or malevolent, the stool of democracy will wobble. If all perform adequately, it will be stable. India has yet to find this stability.

Even funeral directors gotta to eat..

In a rollicking article, the author attends a convention of funeral directors and gives us the lowdown on this burning topic.

It seems that the funeral industry is in the midst of a transition of titanic proportions. America is secularizing at a rapid pace, with almost 25% of the country describing itself as un-church. Americans, embracing a less religious view of the afterlife, are now asking for a "spiritual" funeral instead of a religious one. And cremation numbers are up. Way up. The rate of cremation has skyrocketed as Americans back away from the idea that Jesus will be resurrecting them straight from the grave

Cremation has been touted as the “green” way to depart this coil, and several biodegradable urn choices have become available, their sides ornamented with images of fire, water and earth. To compensate for the relative cheapness of cremation, funeral directors have begun adding a series of value-added services, from a string orchestra, to webcasting for distant family and friends, to a remembrance “rose-petal” ceremony for young attendees. The message attached to all these services seems to be: cremation is green, and if you choose something else, you're a polluter, even in death.

 While cremation is technically “greener” than burial, the burning of the body still releases into the atmosphere whatever you might have embedded in you—dental fillings containing mercury, a hip replacement made of plastic. The newest, greenest thing is called “alkaline hydrolysis,” a process that uses sodium hydroxide (basically, lye) and extremely hot, highly pressurized water to rapidly speed up the process of natural decomposition. The body is placed in a large tube with a square control base (upon seeing a picture, a friend of mine commented that it looked a lot like a bong, and it kind of does), bathed in chemicals and highly pressurized, and in a few hours all that is left is liquid and ash.

At this convention the largest contingent of vendors were hawking cremation-related products: urns with Bible verses on them, urns with dolphins flipping in front of a Lisa Frank-style sunset, rings with diamonds made of ashes, and an iPhone app that lets you know the progress of a cremation. Funeral homes have to invest in the equipment that will guarantee a solvent future and the funerals-peripheral industry, always with its ear to the ground, is entering the cremation game in full-force. For $150 you can have a pendant that can be worn from the neck, filled with the ashes of loved ones trapped in decorative glass.

And you thought living was easy!

The ways of death

A few days ago, I visited an old friend of almost six decades, who had recently lost his wife. By a cruel twist of fate, he had broken his leg a few days after his wife died. As I sat by his bedside in a spanking new hospital, he told us the harrowing tale of the last six months where he had tried all that was known to modern medicine. They had gone through what the medical professionals call " futile care", where the doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, fed through tubes and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it really buys is misery we would not inflict on a terrorist. Yet his wife, a kind, soft spoken, gentle soul had borne all the pain that modern medicine inflicts in the cause of finding a cure and had spent her time in and out of hospitals with cheerful grace. But towards the end the doctors had thrown in the towel, but would not admit it, ( for it is a truism that no doctor ever admits that he cannot cure the patient or that he may have misdiagnosed the disease) leaving the family to face the difficult and agonising choices alone.

I became curious as to how when doctors faced their own end how they prepared themselves. What did they do and when did they give up?  When did they say enough is enough. Ken Murray, a doctor himself, describes how doctors in general face the end and how doctors die?


Of course, like most of us, doctors don’t want to die; they want to live. But they know enough about modern medicine to know its limits. And they know enough about death to know what all people fear most: dying in pain, and dying alone. They’ve talked about this with their families. They want to be sure, when the time comes, that no heroic measures will happen—that they will never experience, during their last moments on earth, someone breaking their ribs in an attempt to resuscitate them with CPR (that’s what happens if CPR is done right). Then how is it that these same doctors administer so much care that they wouldn’t want for themselves? The simple, or not-so-simple, answer is this: patients, doctors, and the system.

To administer medical care that makes people suffer is anguishing. Physicians are trained to gather information without revealing any of their own feelings, but in private, among fellow doctors, they’ll vent. “How can anyone do that to their family members?” they’ll ask. But they are trained to do all they can to preserve human life if the patient so desires.

"To see how patients also play a role" says Ken, "imagine a scenario in which someone has lost consciousness and been admitted to an emergency room. As is so often the case, no one has made a plan for this situation, and shocked and scared family members find themselves caught up in a maze of choices. They’re overwhelmed. When doctors ask if they want “everything” done, they answer yes. Then the nightmare begins. Sometimes, a family really means “do everything,” but often they just mean “do everything that’s reasonable.” The problem is that they may not know what’s reasonable, nor, in their confusion and sorrow, will they ask about it or hear what a physician may be telling them. For their part, doctors told to do “everything” will do it, whether it is reasonable or not."

The system too plays its part. Unless the patient has specifically asked for certain actions not to be taken, the hospital cannot, for example, take a patient off the ventilator or administer certain medicines lest they be sued by the survivors or become embroiled in some litigation. The safest course then is to do all that is availble irrespecitive of costs or indeed reason.

But it seems that for all the time they spend fending off the deaths of others, doctors in general tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But when it is time to go, they tend to go gently.

So can we all. All we need to do is to draft a living will that states "If the time comes when I can no longer take part in decisions for my own future, let this declaration stand as the testament to my wishes. If there is no reasonable prospect of my recovery from physical illness or impairment in which I am suffering continual pain or am incapable of ever again living a rational existence and when I am no longer capable of being consulted regarding my wishes, I request that I be allowed to die with dignity and not be kept alive by artificial means. I request that they administer whatever drugs necessary to keep me comfortable during this period even if it may reduce the length of my life."

If there is a state of the art of end-of-life care, it is this: death with dignity.  There need to be no heroics, and we should all be able to go gentle into that good night.