Berry leads off with a discussion of an old friend well into her "latter years," whose degenerative illness had led to great pain. The doctor's course of treatment was to withhold pain medication that was inhibiting her appetite, with the goal of "getting her back on her feet." Berry contrasts this medical bias toward longevity with the experience of Lord Nelson, who died in the Battle of Trafalgar in 1805 and whose death was eulogized by his biographer, Robert Southey, with the pregnant phrase "He cannot be said to have fallen prematurely whose work was done."
Embedded in this eulogy is a sense of vocation, of life purpose, that is subverted by a bias toward longevity. Berry is wise to say explicitly that he's opposed to euthanasia and assistend suicide, because neither is the point. The point is that, as he alludes to elsewhere, we become more and more parasitic and consequently less and less virtuous as a species when we see life as something to be consumed, and longevity as proof of success, rather than life as something to be embodied, and success as defined by the way we conduct ourselves from age to age. This corrosion of our vision is an accident of our hubris; we see the potential within our grasp to overcome the constraints that life necessarily entails for us--among which are the infirmities and limitations that descend on us as we age and the death than none of us can ultimately avoid. Medication has become the silver bullet we use to defeat the bogeyman of death ("Death no apparently is understood, and especially by those who have placed themselves in charge of it, as a punishment for growing old, to be delayed at any cost"), and we discover too late that this bogeyman is actually our friend, that as the Bible and other ancient wisdom asserts, the progression of life through death is part of what defines us and frames who we were meant to be. Berry addresses this succinctly in the middle of the essay:
We come to form, we in-form our lives, by accepting the obvious limits imposed by our talents and circumstances, by nature and mortality, and thus by getting the scale right. Form permits us to live and work gracefully within our limits. . . . The art of living thus is practiced not only by individuals, but by whole communities or societies. It is the work of the long-term education of a people. Its purpose, we may say, is to make life conform gracefully both to its natural course and to its worldly limits.