'DYING WITH DIGNITY' NOT ISSUE OF COSTS

Medical advances have enabled untold numbers of people to live longer, more productive lives. Many diseases that would have been fatal just a few decades ago have been all but erased.

Today's medicine is a modern-day marvel.

But with the power to extend life comes some tough questions. Who should receive these extraordinary life-saving efforts, and who should make the decision?

A new study suggests that some Medicare HMO cost-cutting practices have allowed some elderly patients to die with dignity. The researchers suggest that these HMOs may be making death more merciful for some elderly patients.

The question must be asked: Are these patients dying with dignity or simply with lower health-care bills?

The patients -- and their doctors -- should have the final say on what extraordinary measures are taken to prolong life.

There is no question that exceptional medical advances pose new ethical debates. How far should efforts be taken to preserve life?

HMOs treat patients under a prepaid agreement rather than the actual costs of care and services. HMOs also reward physicians financially for withholding unnecessary care.

Hopefully these decisions are being made on quality-of-life issues, and these patients aren't deprived of treatments they need. Those who are going to die should be able to refuse aggressive treatment. That's the role and significance of living wills. Family members should also be briefed on the individual's wishes, to make sure there is no misunderstanding when it counts.

That isn't to say that cost containment should not be considered. HMOs and other groups can provide an important watchdog role on unnecessary treatments and costs.

But a patient -- or the patient's family -- shouldn't have to decide life-saving measures based on out-of-pocket costs. The bottom line in America's health-care system should be quality, not profit.

OPEN GOVERNMENT NOT JUS5 GOOD IDEA, IT'S THE LAW

The Scott City Board of Education has rescinded a vote taken during a closed meeting.

It was a responsive move on the part of board members to offset a potentially illegal gathering.

A former Scott City police chief had filed a complaint against the school board. He had gone to a school board meeting to comment on a new gym policy but found the doors locked.

The Missouri Sunshine Law requires government meetings to be open to the public unless one of the exceptions is cited in advance. The governing body must return to a public session for any vote, or to adjourn the meeting.

While the law allows certain exceptions, it doesn't compel any government to meet in secret. Some boards and governments choose to perform nearly all tasks before the public, and that's commendable.

Scott County Prosecuting Attorney Christy Baker-Neel chose not to file a Sunshine Law complaint against the Scott City school board, saying it was a civil matter.

Perhaps Baker-Neel should revisit the law. It actually states that a complaint can be brought by a resident, prosecutor or attorney general.

While the school board rescinded the vote, it fell short of admitting any wrongdoing, and that is unfortunate. Good government is best done in the open with plenty of public participation.

Limiting the district's open gymnasium policy at the high school to one night per week is not a subject that should have been discussed behind closed doors. It isn't only a good idea to meet in open session about such topics, it is the law.