Assisted suicide, hospice care, pain prevention, and a growing desire for control at the end of life are all ongoing issues. Disparate groups have differing opinions of the most appropriate way to treat people at the end of their lives. Physicians feel they are providing heroic measures to patients with little benefit to the patient and at great expense. The public shows a fear of pain and a fear of loss of control. Ethicists endorse the use of advance directives.
Economists worry about the disproportionately high cost of medical care for the dying.
Patients and family members have often been excluded from the decisionmaking process at the end of life. The authors of this study conducted interviews with 461 family members of elderly patients who had died in various settings. The study was designed to describe their perceptions of decisions regarding treatment and symptom relief. In addition, information was gathered to define family and patient priorities to improve care at the end of life. Comments about the practices of hospice care were the most positive at 91 percent.