The moral which I draw from this anecdote
is not that all elderly patients should be kept
alive by all means until the bitter and inevitable end, 
but that the delivery of medical care requires decisions
not by impersonal rule or regulation but
by a skilled and knowledgeable individual
who is personally, professionally, legally and
morally accountable for his/her actions.
The limitation of bureacratic medicine is that neither
the individual who makes the regulations
nor the individual who interprets them
has hitherto been held morally or legally accountable.
So let's begin by demanding of our legisplators
that they pass laws making the administrators,
the CEO's of insurance plans, their boards of directors
and *all* their employees legally accountable
for the consequences of their actions
in just the same way in which practicing physicians
have been held legally accountable.
There are a lot of underemployed lawyers out there.
Let's give them something to do.