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Well done. The personal touch of descrbing how your personal experiences relate to the socio-economic policy disccusion at hand brought this important topic to life.

End-of-life decisions in a population can - and in my opinion should - be influenced by policies of health care providers and systems, as they were in La Crosse as David Kindig described. Public education campaigns, sponsored by non-governmental agencies that have no financial incentives to reduce end-of-life care, would be helpful to support such policies.
As a family physician practicing one day a week at nursing homes, I see many families with mistrust of medical providers and misunderstanding of the benefit of medical interventions. In end-of-life discussions the incentives in my position are 1) to clearly state my medical opinion about what medical interventions are likely to relieve pain and maintain functional abilities, and 2) be available to support the family. My system employs a nurse practicioner and a chaplain who spend part of their time specifically devoted to end-of-life issues. I have learned a lot from them.

Thanks to Dr. Hunter for this thoughtful comment. I did not mean to say that there is not a role for policy "nudges" for organizations and government. The Medicare hospice program which both of my parents benefited from facilitated the end-of-life decisions they made. And the La Crosse Gunderson-Lutheran policy decision to educate about advance directives was necessary for their results. However, I did want to emphasize that this is a decision that properly resides with individuals and families, NOT insurance companies or governments.

The end-of-life issue should be tackled head-on because it uses up 27% of our health care dollars.
The stumbling block has been the inability to find a copy of the Living Will when patients present to the ER or ICU
Simplify finding the Living Will by putting a notation in the drivers license.
Better still, put a chip somewhere in the body that can be scanned.

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