Death is not an option, how you die is--reflections from a career in oncology nursing

With a combined career of over 60 years in oncology nursing, the authors reflect on the critical elements in the question, "How can we afford to die?" Three high-profile patient scenarios in three different decades promised to improve use of advance directives but did not. Recent societal events, including the debates about health care reform, have brought attention again to end-of-life issues and care. Quickly approaching a "perfect storm" of an aging population, an inefficient and costly illness-oriented health care system, and health care profession shortages, the United States will not be able to afford delivering futile interventions. Nurses, who are consistently seen as the most trusted professionals, must take action in strategies the authors present.