| Course | MED 300 Historical and Contemporary Issues in Health |
|---|---|
| Module | Module 6 |
| Paper type | Analytical essay |
| Length | About 650 words, 5 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | BS in Medical Studies |
| Updated | October 2026 |
Free sample paper for MED 300 Module 6
Why Is It So Hard to Stop? Treatment, Hope and Priorities at the End of Life
Student Name
BS in Medical Studies, Arizona State University
MED 300: Historical and Contemporary Issues in Health
Instructor Name
Month Day, Year
Why Is It So Hard to Stop? Treatment, Hope and Priorities at the End of Life
Introduction
In Being Mortal, Atul Gawande describes a medical culture that treats death as a failure and keeps offering one more intervention even when the odds are poor (Gawande, 2014). Medicare data show the scale of the pattern: about one quarter of Medicare payments go to beneficiaries in their last year of life, a share that has stayed roughly stable for decades (Riley & Lubitz, 2010). This paper argues that refusing or limiting treatment is hard because of how hope, fear and communication interact, not because families or doctors do not care about cost, and that priorities should be set through early, honest conversations about what patients value.
Why Doctors Find It Hard to Stop
Physicians are trained to act, and offering treatment can feel like the only way to keep hope alive. Conversations about prognosis are emotionally difficult and often postponed. When they do not happen, care defaults to more intervention. Data from Medicare decedents show this tension: between 2000 and 2009, fewer beneficiaries died in hospitals, yet use of intensive care in the last month of life rose from 24.3% to 29.2% (Teno et al., 2013). The system has moved some dying out of hospitals while increasing intensive treatment just before death.
Why Families Find It Hard to Stop
Families fear that stopping treatment means giving up or abandoning the person they love. Uncertainty makes this worse; if there is any chance, refusing it can feel unbearable. Without a prior conversation about the patient's wishes, families are left to guess, and guessing tends toward doing more.
What Changes When People Talk
Evidence suggests that conversations change outcomes. Wright and colleagues followed people with advanced cancer; patients who said a physician had talked with them about the end of life were much less likely to receive mechanical ventilation, resuscitation or intensive care near death and were more likely to enter hospice earlier, without higher rates of depression or worry (Wright et al., 2008). A related analysis found that aggregate costs of care in the final week of life were about 36% lower for patients who had such conversations, and that higher costs were associated with worse quality of death (Zhang et al., 2009).
Does Less Aggressive Care Mean Less Life?
A common fear is that choosing comfort over aggressive treatment shortens life. A randomized trial challenges that fear: patients with metastatic lung cancer who received early palliative care alongside standard oncology care reported a better quality of life and less depression, received less aggressive end-of-life care and lived longer, a median of 11.6 months compared with 8.9 months (Temel et al., 2010). Palliative care did not take away hope; it gave patients more good time.
How Should Priorities Be Set?
Priorities should be set by patients' own goals, learned early and revisited often. Gawande's questions, what a person understands about their illness, what they fear, what goals matter most and what trade-offs they would accept, offer a practical framework (Gawande, 2014). Health systems can support this by training clinicians in serious-illness conversations, paying for the time they take and integrating palliative care early for serious illnesses. Cost should not drive individual decisions, but when care follows patients' values, unwanted and costly treatment often falls away on its own.
Personal Reflection
As a future physician assistant, I expect to be in rooms where families ask whether to keep going. This paper convinced me that the most important intervention may be a conversation held long before that moment.
Conclusion
Refusing or curtailing treatment is difficult because medicine's culture equates action with care, families equate stopping with abandonment and both avoid hard conversations. The evidence shows that early, honest discussion and palliative care lead to less aggressive, less costly care that patients value, without shortening life. Setting priorities around patients' goals is both kinder and wiser.
References
Gawande, A. (2014). Being mortal: Medicine and what matters in the end. Metropolitan Books.
Riley, G. F., & Lubitz, J. D. (2010). Long-term trends in Medicare payments in the last year of life. Health Services Research, 45(2), 565-576. https://doi.org/10.1111/j.1475-6773.2010.01082.x
Temel, J. S., Greer, J. A., Muzikansky, A., Gallagher, E. R., Admane, S., Jackson, V. A., Dahlin, C. M., Blinderman, C. D., Jacobsen, J., Pirl, W. F., Billings, J. A., & Lynch, T. J. (2010). Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine, 363(8), 733-742. https://doi.org/10.1056/NEJMoa1000678
Teno, J. M., Gozalo, P. L., Bynum, J. P. W., Leland, N. E., Miller, S. C., Morden, N. E., Scupp, T., Goodman, D. C., & Mor, V. (2013). Change in end-of-life care for Medicare beneficiaries: Site of death, place of care, and health care transitions in 2000, 2005, and 2009. JAMA, 309(5), 470-477. https://doi.org/10.1001/jama.2012.207624
Wright, A. A., Zhang, B., Ray, A., Mack, J. W., Trice, E., Balboni, T., Mitchell, S. L., Jackson, V. A., Block, S. D., Maciejewski, P. K., & Prigerson, H. G. (2008). Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA, 300(14), 1665-1673. https://doi.org/10.1001/jama.300.14.1665
Zhang, B., Wright, A. A., Huskamp, H. A., Nilsson, M. E., Maciejewski, M. L., Earle, C. C., Block, S. D., Maciejewski, P. K., & Prigerson, H. G. (2009). Health care costs in the last week of life: Associations with end-of-life conversations. Archives of Internal Medicine, 169(5), 480-488. https://doi.org/10.1001/archinternmed.2008.587
Reading the MED 300 Module 6 assignment instructions
The Final Paper in MED 300 is worth 40 points and is worked on throughout the course, then submitted at the end of Module 6. Choose one of the syllabus's discussion questions about Being Mortal and end-of-life care, or a related theme from the readings, and answer it by integrating the text, articles and your reflections. The body should fill three to five double-spaced pages in APA style; title and reference pages come on top of that. It must use at least five peer-reviewed sources that were not referenced in class. A paper turned in up to a day late drops a letter grade; after that it earns nothing.
How the MED 300 Module 6 example is put together
The sample introduces Gawande's argument and a Medicare spending statistic, then states a thesis. Separate sections explain why doctors and why families find it hard to stop, using national data on ICU use. Two evidence sections report studies on end-of-life conversations, costs and early palliative care, the second answering the fear that comfort care shortens life. A section on setting priorities offers a practical framework, followed by a short personal reflection and a conclusion. Each section answers one part of the question, and the evidence builds from the size of the problem to what changes it, which makes the conclusion feel earned. The personal reflection is kept short so the paper stays analytical.
Reading the MED 300 Module 6 grading rubric
The final paper is worth 40 points. Readers check that the student answers one question directly, that at least five peer-reviewed sources not used in class support the argument, that the course text is integrated, that the reasoning is clear and that APA format and length are followed. Marks drop for papers that summarize Being Mortal, that rely on class readings alone, that use fewer than five outside sources and that miss the required length. Graders also look for engagement with the book's argument rather than a summary of it, and for honest treatment of counterpoints, such as the worry that palliative care means giving up. Papers also gain when each outside study is tied back to a scene or patient from Gawande's book.
MED 300 Module 6 help from the desk
Pick the question you have the strongest opinion about and write a one-sentence answer as your thesis. Search PubMed for studies on that question, such as end-of-life conversations, costs or palliative care. Use the book for framing and the studies for evidence. Keep a personal note brief. Check the five-source rule against your reference list before submitting. If you are unsure which question to choose, the desk can help you weigh them. Start the paper early, as the syllabus intends, and collect sources as you read the book. Keep a running list of quotations and page numbers. Read the question again before submitting to confirm you answered it directly. Draft the thesis first, then pick sources that test it rather than sources that merely repeat it.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More MED 300 and BS in Medical Studies sample papers
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- MED 300 Module 3: Module 3 Reflection: The Health Care System and Professional Identity
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- MED 300 Module 5: Module 5 Reflection: Humanistic Health Care and Ethics
- MED 320 Module 6: Part 4: Final Ethical Analysis Paper
- MED 475 Module 7: Case Study: Palliative Care or Hospice? Deciding What Fits a Patient Now
MED 300 Module 6 questions, answered
Where can I find a free MED 300 Module 6 sample paper?
The full final paper on why it is hard to stop treatment at the end of life is on this page.
How long is the MED 300 final paper?
Three to five pages, not counting title and reference pages.
How many sources does the MED 300 final paper need?
At least five peer-reviewed sources not referenced in class.
What share of Medicare spending goes to the last year of life?
About one quarter, a share that has been roughly stable for decades.
Does early palliative care shorten life?
In one randomized trial of metastatic lung cancer, it was associated with longer survival.