I’m not sure if it's realistic or pessimistic to think that the end of life costs debate is unresolvable from the frame it’s currently approached. As end of life relevant technology and pharmacology spirals in options and costs, there is no foreseeable end to our debate about imposed or allowed limits. Arguments about what constitutes the biological and religious requirements for “life” add more heat than light to the problem.
As usual with wicked problems, we have to change the frame to get anywhere different.
One idea is to require any person or family with stressful cost-implicated end of life decisions to go through the process with coaching in meaningful end of life conversations. These are with each other or if possible with their beloved.
No amount of costs can address people’s incapacity for the kinds of conversations that make letting go more possible and meaningful. No technologies or pharmacologists can replace the power and efficacy of authentic conversations when life ends.