Henry Marsh in More Intelligent Life:
It is estimated that in developed countries about 75% of an individual’s lifetime medical costs are spent in the last six months of life. This is clearly money wasted. We are wired by evolution to fear death, to cling to life, and yet in the modern world, where most of us will live into our 80s or beyond, extra life is often bought at the cost of gruesome treatment, such as chemotherapy, or prolonged incarceration in miserable hospitals. And even if the treatment is successful, as so often it is not, it may well allow us only to linger on a little longer in a nursing home, with the chances of dementia increasing steadily with age. When doctors like me face these difficult decisions as patients, they seldom choose the same solution for themselves that they often recommend to their patients. I hope that my grandchildren, not as doctors but as educated consumers of health care, will be appalled at the way that so much suffering was inflicted on the elderly in the past. I hope that the doctors of the future will be able to provide patients with better and more realistic predictions of what treatment will achieve, and that they will be more honest.
All over the world, health-care costs are escalating beyond the rate of inflation, which is not sustainable. Much of this is based on folly, greed and denial of the inevitability of death. I hope my grandchildren will understand that the problem facing us is not how to live a long life, but how to live a good life, and how to end it with a good death.