Resisting the blame game: visualizing the high cost of dying and acceptingthe duty of technology stewardship for all patient populations. A review

This article explores the concepts of therapy withholding and withdrawal as expressions of technology stewardship. With the world's geriatric populati on growing sharply, and advances in medical technology announced almost wee kly, the time is ripe for the application of technology stewardship to pati ents of all ages, rather than arbitrary allocation limits for older persons . In life and in death, health care costs are expensive, and while society often views older people as too expensive to take care of alive, their deat h can be even more costly. For patients of all ages, death under the influe nce of technology is more expensive than life, yet it is geriatric intensiv e care medicine that grabs society's economic attention. While possibly not the financial bargain that arbitrary allocation limits have been proposed to be, technology stewardship fosters beneficence and autonomy as human val ues instead of mere variables subservient to economics. (C) 2001 Elsevier S cience Ireland Ltd. All rights reserved.