Poll after poll shows Americans want the right to determine the measures taken to keep them alive. While the percentage who say, “I approve any measure that keeps me alive” changes a bit over time, the vast majority do not want extrodinary measures.
The dark side of keeping people alive is that extrodinary measures are suspected of shorting life often. Surgeries on very sick people can do this.
I read somewhere recently of a new model for end of life care. It involved an advocate for the patient who would visit often about the patients short-term goals.
That is, instead of signing a sweeping declaration about extrodinary measures, the patient is asked what he/she would like to do or accomplish during there end of life period. It might a visit with someone special or a trip to experience somthing. The consultant then arranges with doctors in efforts to accomodate these wishes. Decisions about the level of health care are made by the patient through the consultant rather than by doctors.
That model sounds similar to the way I understand end of life medicine is practiced at the famous Mayo Clinic in Rochester. The clinic spends extra time (money) listening and consulting with the patient.
Patient feedback from Mayo patients and relatives is very positive. Ironically, their costs are lower than competing clinics.
Even though forgoing some end of life care can be seen as a form of suicide, it seems to me patients should have substantial control of what happens.