Despite the increase use of Hospice and palliative care for en-of-life situations, costs continue to rise.  Harding (2010) estimates that one third of overall healthcare costs are associated with care surrounding the last year of life.  This is a staggering number.  Another article by CBS News (2010) stated that "Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients' lives."  Is this justifiable?  What do you think?  This is actually more that the entire Homeland Security budget.  Furthermore, 20-30% of these expenses do not have any meaningful impact.  Much like the Youtube video in the previous post.  When assessing individual patients who are hospitalized at end-of-life, many (18-20%) are in the ICU which can cost up to $10,000.00 per day.  Is it acceptable, both morally and ethically for the government to be paying such extreme amounts of money to prevent the inevitable?

     Not only is it important for us to review the costs associated with end-of-life care but is is also necessary for us to determine to what extreme do we, as a population, want to continue this type of spending and at what cost?  What are we willing to give up to continue on this path?

Prior to answering these questions, we must first identify:

1.  The role of the nurse.
     AACN Competencies

2.  Review Nursing Theory that can be applied to end-of-life care, such as Jean Watson's Caring Model.

3.  Define Death and Dying.

4.  Examine alternatives for care:  Palliative and Hospice care.

5.  Review both legal and ethical issues with end-of-life care.

6.  Identify the purpose of the Advance Directive.

7.  Discuss Living Wills and the importance of having one and the impact on care.

8.  Review some high profile case studies surrounding the Right to Die.

                                                                 References

Harding, A. (2010). End-of-life care costs continue to climb upward. Retrieved from           http://www.reuters.com/assets/print:aid=USTRE69C3KY20101014

The cost of dying:  End-of-life care. (2010). Retrieved from http://www.cbsnews,com/2101-18560_162_6747002.html?tag=contentMain;contentBody