The last people that should be explaining end of life options are the physicians and providers who have the most to lose by accepting the decision of the patient.  My experience is I have never heard a physician nor a social worker properly explain what the decision entails.  It isn’t a death wish.  It isn’t a plan.  It isn’t a matter of cost.  It is a matter of accepting end of life as inevitable and it happens at different times for each individual … so making it a checklist or form complicates what should be devoid of costs/incentives or physician/provider/family opinion.

As an administrator in skilled nursing faculties I have many times had to intervene and let the patient know that it is not a decision to end their life … it is their choice for accepting death as inevitable and sustaining it too long is very painful physically, socially and only extends the pain.  A peaceful approach with the patient is the best by gaging their  current condition as confirmed by the physician.  Then decide in writing at that moment the decision and realize that decision may and can change.  Otherwise as the government always does makes, something  that should be simple, complex so only an attorney or judge can figure it out at a cost of the patients’ dignity and paid for by taxpayers.  And they now want to pay an incentive for something that will only complicate the event.

Obviously I’m adamantly against paying physicians or providers for making it worse than what it is now … impossible to administer.