In this thoughtful article at Pro-publica, Charles Ornstein discusses our need to come to grips with end of life decisions:

[T]he high cost of end-of-life care is an issue worthy of discussion. About a quarter of Medicare payments are spent in the last year of life, according to recent estimates. And the degree of care provided to patients in that last year — how many doctors they see, the number of intensive-care hospitalizations — varies dramatically across states and even within states, according to the authoritative Dartmouth Atlas. Studies show that this care is often futile. It doesn’t always prolong lives, and it doesn’t always reflect what patients want.