Last night a very interesting segment of "60 Minutes" aired called "The Cost of Dying". It focused on the large amount of money that Medicare pays for individuals during their last two months of life. There was a physician from Dartmouth on the program that discussed that these costs are usually related to patients' and families' inability to accept death. I thought the points that this physician made were excellent. As a Hospitalist, I admit patients who are near the end of life on a daily basis and I have daily end of life/code status dicusssions were I am frequently frustrated by the patient's decision to be a "full code". I had an outstanding attending in residency who told me that "sometimes you just tell them that you are not going to code them and they will be DNR." His explanation was that patients sometimes do not have the comprehension of their disease or the ability to say "let me die". I totally agree with this. I think the next question is should patients have a right to decide their code status? Is it really even fair to ask them this question? I think we are going to see more discussions like the one on "60 Minutes" as health care reform progresses. In fact, I think we are obligated to look into this issue.