7. Any attempt to limit end of life medical treatment is going to run into trouble on multiple fronts.
Some cultures do not want family members to die at home---so their family members will be in hospitals and will get the works. Some cultures do not trust the system---they will insist that "everything" be done, because they have seen how too little gets done for them if they do not raise a fuss. Then there are the doctors. Since death in the hospital is an "adverse outcome" that triggers an automatic review, doctors will order every possible test and consult in order to shield themselves from criticism during the review. And, of course, there will be hospitals secretly or not so secretly lobbying against hospice spending, because they make so much money providing futile, painful care for the dying. Don't forget the family member who has neglected the dying person for years and who suddenly shows up at the last minute to demand that the hospital "do everything possible" as a way of easing his or her own guilt. No matter how iron clad the dying person's living will, all it takes is one relative raising a stink for the living will to get tossed out the window. In these hard economic times, grandma's Social Security may be all the income that some folks have. They will be desperate to keep her alive, even if "alive" means on a ventilator in a coma.