That should be placed on the backs of the insurance companies who provided policies (and still do) that cover everything. My take on end-of-life care is that I want them to keep me alive until I AM THE ONE who says ‘no more’.
I don’t want some bureaucrat making that decision, nor do I want some covert doc or nurse running around pulling plugs. I don’t believe in so-called ‘living wills’ because they are terribly abused.
My closest family will know what I intend, and what not to say to anyone, because I don’t trust the system. If I’m paid up, then the system should deliver what they took my money for.
Here's how things usually shake out.
The (already sick) patient has a downturn. There is about fifty percent chance that it will lead to permanent kidney failure, which will lead to dialysis, and about six months to a year in the ICU and ultimately other organs will fail and the patient will be dead.
If nothing aggressive is done, then, the patient will be dead in two weeks' time with much less money spent (say 1.5 million dollars to 3 million dollars.)
OK, what do you do when you approach the patient, or, if he is too sick to think straight, the family? What would you want to yourself? What would you want for your relative?
The problem now is that most everyone, indigent or otherwise, opts for the aggressive approach, largely because there is no financial penalty for it, if Medicare is involved. Someone else (taxpayers) are picking up the tab.