Jarvis," I asked my husband, "should we have a discussion about end-of-life care?"

"Yes," he said. "We need that discussion -- almost in religious terms."

I wasn't sure what he meant. The reason the whole subject comes up so much nowadays is political: Who would pay for end of life care? I reminded Jarvis that, according to a July Wall Street Journal article, most health care spending in general occurs in the last six months of life. And a recent UC Berkeley report noted that health care accounts for 16 percent of our gross domestic product; it will increase if nothing is done, providing a huge drag on our country's economy.

"All the more reason we need that conversation," Jarvis said.

We were outside, sipping Chardonnay. It had been a brilliant blue-sky day, a good day to be alive.

"The medical technology we have is wonderful," Jarvis said. "All those machines that can help someone, after an accident or illness, breathe and digest nourishment and sustain a heartbeat until they recover: It's fantastic. But for someone with a terminal illness? We may be forcing food into the bloodstream and pumping air into the lungs, and actually detaining someone God is trying to call home."

So that's what Jarvis meant about religion. I thought it was a beautiful way to put it.

I already knew that the incorrect use of phrases such as "death panel" had only complicated talk about health care. As I understood it, the current health-care proposal called for funding for an optional consultation about end-of-life-care. A discussion. Even long before a person became ill.

I have seen living corpses in Intensive Care, living out their last days and months of life tethered to machines, their agonized relatives able to visit them for only minutes in the hour. Did those people ever wonder if, in some cases, they might have been interfering with God's plan? Even the Catholic Church has said we do not have to use artificial means to prolong life. It is all right to remove the ventilator, to let nature take its course if a sick person can no longer be made well.

The concept of hospice care has become increasingly popular as a way to let nature take its course, and also to control cost. In 1985, the federal government made hospice benefits a permanent part of Medicare. Is that such a bad idea?

Jarvis said thoughtfully, "Some of my most conservative friends have used hospice." He mentioned a retired Westinghouse executive who had fallen ill, grateful for hospice care at the end.

My own father, 82, had hospice care. In 1992, he was dying in then-Presbyterian University Hospital of myelodysplasia. Frequent blood transfusions made his skin blotched from bruises, his muscles atrophied from weakness. The transfusions were becoming even more frequent. It was clear that if they went on, only hourly transfusions would keep him alive. And then?

My father decided to forego the transfusions and enter a hospice facility, where comfort was the only goal. He was completely lucid; he had talked to his Catholic priest and made the decision himself. In Forbes' inpatient unit, he could eat, drink, laugh, visit his family constantly. He lived there for six days before he died. I have since become a volunteer at Forbes Hospice, hoping to help other families as much as we were helped then.

Jarvis interrupted my thoughts.

"You know who'd be good to talk to about all this?" he said. "Bill Barker."

Jarvis's brother-in-law, the Rev. Bill Barker, founded Bower Hill Presbyterian Church in Mt. Lebanon and served a long ministry there. Bill and his wife now live on Cape Cod, where we promptly reached him. His voice on the other end of the line was cheerful, and he sounded happy to hear from us. I explained that Jarvis and I were talking about end-of-life things.

"As a minister, I've seen so many cases where technology doesn't prolong life," Bill said, "as much as prolong death."

I told him what Jarvis had said, that maybe we were interfering with someone God was trying to call home.

"That's a good way to put it," Bill said. "And it's personal for me. I had a friend in Allentown, a physician, the kindest person and most wonderful friend you could imagine. Even before he got sick, he had filled out papers saying he did not want to be resuscitated if there was no hope for recovery. But when he did get sick, they somehow ignored those papers. I was there. The family had asked me to be there. I saw the doctors break his sternum in an attempt to resuscitate him. And for what? To live a few more hours? He was in agony.... They tried to sedate him. He died anyway a few hours later."

Bill continued, probably enunciating a philosophy he has articulated in many a sermon. He talked about the need to stay healthy, to take medicine if it's prescribed, to eat well and care for our planet without polluting it, to share our bounty with creatures of the wood ... to take care of ourselves, and even more importantly, to take care of others.

"Doing more than that is sometimes to deny that we are mortal," Bill continued. "I'm much more concerned about that care, for ourselves and for others, than I am about living to be a hundred."

Bill mentioned the work of Sherwin Neuland which had influenced him, and also the 90th Psalm.

Night was falling when we finished talking to Bill. Jarvis and I looked at the last red streaks in the sky, and we felt the need for the exact words in the Psalm Bill had quoted. We looked them up, and felt humbled:

So teach us to number our days

that we may apply our hearts unto wisdom.

Perhaps some wisdom comes from continuing to talk.

Cartoonist Rob Rogers does "Rob's Rough," an early look at his work and his creative process, exclusively at PG+, a members-only web site of the Pittsburgh Post-Gazette. Our introduction to PG+ gives you all the details.