Letting Go by Atul Gawande is a description of typical end of life care in the US, and how it can and should be done better.
Typical care defaults to taking drastic measures to extend life, even if the odds of success are low and the process is painful.
Hospice care, which focuses on quality of life, not only results in more comfort, but also either no loss of lifespan or a somewhat longer life, depending on the disease. And it's a lot cheaper.
The article also describes the long careful process needed to find out what people really want for the end of their life-- in particular, what the bottom line is for them to want to go on living.
This is of interest for Less Wrong, not just because Gawande is a solidly rationalist writer, but because a lot of the utilitarian talk here goes in the direction of restraining empathic impulses.
Here we have a case where empathy leads to big utilitarian wins, and where treating people as having unified consciousness if you give it a chance to operate works out well.
As good as hospices sound, I'm concerned that if they get a better reputation, less competent organizations calling themselves hospices will spring up.
From a utilitarian angle, I wonder if those drastic methods of treatment sometimes lead to effective methods, and if so, whether the information could be gotten more humanely.
The framing of the end of life issue as a gain or a loss as in the monkey token exchange probably makes a gigantic difference in the choices made.
http://lesswrong.com/lw/2d9/open_thread_june_2010_part_4/2cnn?c=1
When you feel you are in a desperate situation, you will do desperate things and clutch at straws, even when you know those choices are irrational. I think this is the mindset behind the clutching at straws that quacks exploit with CAM, as in the Gonzalez Protocol for pancreatic cancer.
http://www.sciencebasedmedicine.org/?p=1545
It is actually worse...
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