Paralleling the expansion of the complexity of our society, medical decision making has become intensely intricate. Given this technological explosion that geometrically multiplied the possibilities and nuances of end-of-life decisions, the processes for making fully informed decisions became overwhelmed. The interest in end-of-life, medical decisions encompasses the patient, his or her physicians and family, health care administrators, and all parties engaged in protecting the public welfare. At one narrow window in time all parties must have a clear, personal understanding of: 1) the importance and meaning of informed consent; 2) the content of and process for advance directives; 3) the legal status of patient surrogates; 4) the economic issues involved in medical care; 5) the circumstances surrounding medical futility; 6) the spectrum of euthanasia; and 7) the perception of panic at the moment of acute emergency. For the patient and those who care, it is only when these concepts gel that the toughest decisions one will ever have to make can become conceivable.
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