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Editorial |

Death, Dying, and End of Life

Howard Bauchner, MD1; Phil B. Fontanarosa, MD, MBA1
[+] Author Affiliations
1Dr Bauchner is Editor in Chief and Dr Fontanarosa is Executive Deputy Editor, JAMA
JAMA. 2016;315(3):270-271. doi:10.1001/jama.2015.19102.
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In 2014, approximately 2.6 million people died in the United States, and approximately 55 million people died worldwide.1,2 Death is inevitable, but people die from many different causes and in many different environments. Most individuals at end of life want to be surrounded by family, in familiar settings, and with a chance to say their good-byes.

Currently, the United States and other nations are engaged in important debates and discussions involving the end of life and how to die well. Among the factors prompting increased attention to these important issues include the aging of the population; the increasing recognition that doing everything possible to prolong life, such as intensive care or chemotherapy for patients with terminal illness, is not always appropriate or desirable; the growing awareness of the importance of advance directives and self-determination about end-of-life decision making; and the well-documented finding that health care spending during the last year of life represents a significant amount of health care costs and accounts for a substantial proportion of total Medicare expenditures, with approximately 60% of spending during the last 6 months of life among Medicare beneficiaries occurring during their final month.3

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