I’m not certain when small-talk banter started to include a suggestion to "consider the alternative," but since I passed the six decade mark, I know it has become more common.

Well, consider the alternative.

The first alternatives that leap to mind are sleeping well at night and regaining my speed on the squash court, but, of course, those are not the alternatives implied. Death, it is suggested, is worse than lying awake all night or lumbering about the court in the shadow of your former self.

Well, the truth is that I do consider the alternative, quite a bit. It’s difficult not to when you see and read about all the dimly lit ways to dusty death — dementia, pain, helplessness, incontinence, immobility, indignity, forgetfulness. Is living with the litany of loss and suffering that ends in death somehow preferable to ducking out a side exit just before that long corridor? Questions like this seem to embarrass or scare us so much that we resist even discussing them.

A couple of years ago, I began to notice the growing ubiquity of defibrillating paddles. Some public buildings have them mounted to the walls so that passersby can jolt us back to life in the event of a heart attack. The thought of being revived so that I can die again later terrifies me. I’m not interested in returning to the miracles of being cut up or irradiated so that I can live a reduced life and die again later. I want to die only once; that will be plenty I think. So I made an appointment with my doctor to discuss how to get a “do not resuscitate” order. Although he helped me get the DNR bracelet, the discussion made him uncomfortable.

Propriety expects us to want to stay alive at all costs. Any talk about alternatives to suffering — suicide, death with dignity, euthanasia — is considered almost obscene. We assign it the face of Dr. Kevorkian and lock it in prison. We seem reluctant to imagine physical or psychological suffering so great that death is a reasonable release.

Let me be absolutely clear: I have no interest in dying. I love life. When my time is up and I must die, I imagine I’ll react like everyone else: I will not want to depart, and I will be frightened. But, unless death surprises me and snaps me up like a frog snagging a fly, I want the freedom to choose how and when I go. Living wills and overly regulated assisted-suicide laws miss the point. I imagine only a brief window of lucidity between the freedom to act and the prison to which some incapacitating disease consigns me, making my exit so much more difficult and protracted. I’d prefer a gentle, painless fade to black over a lingering agony, especially when that agony is likely also to devour the people I love and drain the funds that should go to support my wife.