Scandinavia is OK, not what many people in the US would call great. My uncle had prostate cancer, was basically put in hospice to die. He was kept comfortable and it was a nice place, but he was in his 70s and basically written off. And I'm not even saying that's the wrong approach. His life expectancy was in single-digit years at that point regardless, so why spend a lot of money on low probabilites of success? But a lot of people in the US think that every effort should be made, no matter how hopeless the situation or how much it costs.
People are afraid of government 'death panels' while completely ignoring the fact that such panels definitely exist now, but they are opaque. Try arguing with the insurance company when they've decided to deny your coverage.
A long while back, my brother worked for a local "non-profit" health insurance company. Same part of the building as some of the lawyers. They'd brag amongst themselves in the break room about the various ways they'd managed to avoid responsibility for paying a big claim. He ended up quitting his job because he couldn't stomach working in that environment.
Having seen all four of my grandparents go through their end of life, I came to the conclusion that we treat our pets with more compassion than some of what our elderly (or terminally ill) fellow human beings must endure.
I don’t think every effort should be made, at least not in every case. I don’t think every effort should even be offered in many cases.
I don’t know the exact line for me, but if there’s no reasonable prospect for 3 months of out-of-hospital life, maybe palliative care is the most humane thing. In some cases, active intervention should be able to be requested by the patient (with reasonable oversight).
It’s not primarily for money reasons, but a shocking percentage of healthcare dollars are spent in the last 1 month of patients’ lives. Some of that is intensive care for patients after trauma or other acute incident and that care should continue. But a large part of that is spent on futile efforts, what one surgeon friend of mine called “warm autopsies”.
