End of life care is difficult and comes at an extremely emotional time. One forth of all health care dollars are spent on the last year of life. This care almost never effects outcome, and compounds the patient’s suffering and the families anguish. So why do we do it?

Anyone losing a loved one feels the emotional pain of anticipated loss and the desperate wish to undo the inevitable. I’ve recently been through this with the loss of both parents two years ago. We all have an unreasonable expectation of medical science to fix that which cannot be fixed. Medicine actually feeds into this belief. I recall so many times a family member saying “Do all you can, Doc, we can’t lose her!”

As the saying goes, if you live long enough, you are going to die. You will likely have a period of illness and disability before you die. Most doctors choose not to take the end of life care they recommend to their patients! A recent survey of physicians showed most will not end their lives in a hospital, but will choose a natural death at home on their own terms. I decided this long ago, as an Intern declaring people dead on a cold, lonely ward at three AM. So, why is this still the practice?

We need to educate the public about the realities of end of life care, and, more important, the options. Plan your own death; how you and your family would be most comfortable. Be realistic about what the healthcare system offers. Being at peace with your mortality will actually give you a deeper peace beyond this issue. And, as a society, perhaps we can visit shifting these resources, so limited now, back to those likely benefit from them for decades, rather than months. Your doctors have made this choice already for themselves.