On New Year’s Day, the San Antonio Express News chose to run the following editorial, which first appeared in the San Jose Mercury News. Here it is: “A gift Americans owe to themselves and their country in 2013 is lessons on how to die. Doctors know this. They don’t spend their final hours like the other 2.4 million Americans who die every year. They’ve seen patients hooked up to tubes in hospital beds, suffering unnecessary pain and indignity, while tens of thousands of dollars are spent on every medical option to extend lives that are clearly near the end. According to a Johns Hopkins study, most doctors have advance directives, reject CPR and live their final days with dignity, at home or in a hospice, surrounded by loved ones. Pain can be managed very well today. Most Americans could die in peace at home. But nearly 80 percent die in hospitals or nursing homes, even though surveys show that these are the last places that the vast majority wants to be. About 20 percent die connected to tubes in intensive care units, the least humane and most expensive end-of-life care. We need a culture change in our approach to death. We need to focus more on dying with dignity and less on extending life to the last possible minute. This will be better for individuals and better for America: Our health-care costs are killing our economy, and pointless end of life care is a big part of the reason. The 5 percent of Medicare patients who die every year consume almost one-third of all Medicare expenditures. One-third of those costs are incurred in the final month of life, when there is no chance of a real recovery. Today 75 percent of Americans could die comfortably at home with hospice care. But we have to make that choice personally, talk frankly with doctors and family—and change family and community attitudes. All we need is the will.” Well said, indeed.

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