A Caregiver's Decision to End Two Lives Re "Respect the Future" (column, April 3), about the murder-suicide by Charles Darwin Snelling, whose wife had Alzheimer's disease: Like David Brooks, I, too, was deeply moved by Mr. Snelling's reflection on his late-in-life experience caring for his wife. Perhaps it was less remarkable to me since I have been in his place for a number of years now, and his response to the challenge so closely paralleled my own. I understood so well where he was coming from. But the end of his story I cannot fathom. Taking the life of someone whose love was surely gifted to me by some power beyond my knowing would be unthinkable. For if I have come to comprehend anything from my experience, it is simply this: the person you have long known and loved who is no longer there is still there. Another way to look at the tragic outcome of the Snellings" deaths is that the fragmented health care system is simply not adequate to provide the support that the Snellings needed. Countless people soldier on quite alone to care for a loved one with dementia. Supportive services in the home are very expensive. Loving family members can provide only so much to compensate. If appropriate and affordable services had been available to him and his family, Charles Darwin Snelling might have had enough measure of reprieve to continue daily life and eventually imagine and then live a better future. The writer is a clinical professor of health services, policy and practice at Brown University. David Brooks speaks compellingly of the emotional roller coaster that accompanies the care of an Alzheimer's patient. Without condoning Charles Darwin Snelling's decision to give up and take his own life and that of his wife, I find Mr. Brooks's argument naïvely optimistic. Having experienced my mother's 12-year decline into the depths of the disease and witnessing the waning of her awareness and spirit, I can attest to the sad fact that her natural death was a heartbreaking relief to those close to her. Hearing Mr. Snelling's story of dedication during those six years of his wife's illness suggests that his action was taken with regret but with recognition of the irreversible. The disease is one that ravages the individual and eats at the heart of loved ones. Knowing that there is no hope of recovery and that each day brings further decline and decay, the "mysterious flow" of life of which Mr. Brooks speaks somehow loses its mystery. Maybe Charles Darwin Snelling should have allowed his wife to be cared for in a facility where he could have visited as often as he wanted, relieving him of the demands of 24/7 care as he watched a loved one deteriorate. My mother had Alzheimer's and lived in a nursing home for the last two and a half years of her life. Though my mother didn't recognize me, I wondered how she felt in herself. Perhaps she experienced a richness I couldn't perceive; perhaps her sense of self - her soul - was even more expansive or satisfying than my own. Maybe Mr. Snelling had stopped believing that his wife still possessed an inner life, or thought her pain greater than any rewards of living. But how could he be sure? Three instances of suicide in recent months lead me to deeply question the "right" to take one's life, let alone to take another person's life. One involved an older friend, a doctor here in Oregon who championed our "right to die" law. Another involved a man in his 40s who suffered from bipolar disorder. And now the murder-suicide of the Snellings. I question whether there can truly be a "decision" in these situations. What is pulling the strings: a true decision-making power, connected to the depths of oneself, or forceful impulses that, in David Brooks's words, "foreclose future thinking"? The right to "decide" something related to life and death bears a tremendous weight. A real decision begins with efforts to see and bear all of the impulses operating in and around us at the moment - what we want, what we feel compelled to do - and to affirm life by living. JAMES OPIE Portland, Ore., April 3, 2012