It stinks that doctors likely won't. They seem the best qualified. They know what the patient has. They know what the outcome will likely be. They know the quality of life issues. And they know the cost. Let them work with insurance companies to say, "it's cash". No medicare, medicaid or other insurance if you want us to do brain surgery after granny's 10th stroke. It's going to cost $100,000, her brain is already gone and she'll be dead within months. Cash or charge?