Abstract
Health care providers are increasingly concerned about the rising costs of the total health care system, which is now approaching 10–12% of the gross national product (GNP). The long-term decrease in birth rates and the prolonged mean length of life of the population shifts the age pyramid to older ages, bringing a higher demand for health care at increasing costs. Another explanation for the rising health care expenditure is the application of modern medical technologies in the treatment of the terminally or critically ill at any age. It has been estimated that 1 of every 7 health care dollars is now consumed by patients who are within 6 months of the end of their lives (5).