Their path would take the unfortunate to the hospice or home to die (at the individual's and his or her family and friends, or charity, religious institutions', etc., own expense). The ultra-Demmies would not only be gung-ho about euthanasia, but would promote it (the Ad Council and your tax dollars at work), if for no other reason than for some hoped-for guilt reduction (and rationalization of various kinds). More “moderate” or “centrist” Dems would settle for pro-euthanasia ads and (heavy?) counseling about end-of-life issues (tending to leave the decision still in the hands of the individuals, unlike uber-Dems).

That's the horror story as interpreted conventionally. (Nice movie script were it not that it involves present and future federal government entitlements, including health care.)

Improved palliative care (including permitting the use of heroin, etc., when pain is extreme) is something long neglected and identified as part of the solution against a slippery slope that can develop with the practice of euthanasia.

Don't forget the explicit anti-generic Insist On Lipitor ads, too.

I've long wanted these ads (including “pester your doctor to allow you to buy X” along with anti-lawsuit standard side-effect warnings) to be banned. If tobacco ads can be banned at least sometimes, why not these things?

Allocation and “futility” are, in fact, stand-alone issues in addition to cost-benefit issues and overall “appropriateness,” not to mention competition for eventually more-scarce resources.

“it is cowardice to put the intellect on standby”

Or to engage in distraction, or react out of defensiveness (and cowardice), by mischaracterizing the serious concerns of those with more intellect and (nobably, too) moral substance (including making the distinction between the dispassionate and factual issues, and wishes and resentment at not receiving instant gratification, or at least much of it this year).

Issues clarified and corrected…

From my personal experience, the core of the problem is that, frankly, most people feel it's monetarily cost free to pursue any option available to them. In particular, when one is on Medicare, and has an attitude that they “paid into the system” and thus should be able to demand and receive any medical option, even one that the research does not bear out as effective. If Medicare patients, or families, were responsible for even 10% of the cost of the care they receive, you would see a lot more cost consciousness.

Even if a patient asks to have a DNR/DNI order in their chart, if they become unable to reiterate that wish, family often steps in and changes the order to Full Code, which means we have to do everything we can to resuscitate them, in the event of a code. I have seen some of the most egregious examples of people who we could allow to die peacefully, be resuscitated, at tremendous pain and suffering, all at the wishes of the family.

Soultions? As a nation, we need to have a huge push to educate about hospice and comfort care. I do believe many, many sick people would choose to be made comfortable and pass away in their own home, with family present, rather than in an ICU, with machines alarming and people running around. We need to educate to prepare patients and family for the inevitable end we will all face, in a compassionate and respectful, yet fiscally responsible manner.

This does mean that we are going to have to deny some people all-you-can-can-consume care. We have no other choice, or WE are going to be consumed by these costs.