This would not reduce costs if there are enough people like me. Let me explain:
I assign a utility score of negative infinity to my own death. If the outcome for no treatment is zero percent chance of survival, but the outcome for a treatment that costs some large finite amount C [1] and raises survival chance to epsilon percent chance of survival for some epsilon (nonzero but potentially small), then I would opt for C every time.
This means if there's a way I can convince people to spend a billion dollars to try to cure me, I'd do it. Even if there's a 99% chance I die anyway and it means all that money couldn't be used on a better project, even if successful treatment meant I was in debt to a billion dollars which I could never repay, so I became bankrupt and my entire family would go to debtors' prison for life [2], that's still better than being dead.
Even if I had to kill a healthy child with my bare hands and drink their blood for the treatment [3], I'd still do it even though this scenario results in net negative utility for the human race (one for-sure dead child and one living adult with a 99% chance of dying is clearly a worse outcome than one living child and one dead adult.) Because I'm not interested in the utility of the human race; I'm interested in maximizing my own utility (one percent chance of being alive is still infinitely better than zero percent chance of being alive).
So my advance directive would be "hold at all costs: Liquidate everything, put me through prolonged medical torture if you have to, but the top priority is to keep me alive at any price."
[1] In "costs," I include not just money but my own prolonged pain and suffering; emotional distress of family members; violation of ethical standards; etc.
[2] This hasn't been a real thing for over a hundred years. I guess the modern equivalent is spending your childrens' college fund.
[3] If you believe that life begins at conception, this is basically what stem cell treatment entails.
If that's what everyone wishes, so be it – but it should be in writing, and discussed with your friends and family, regardless of if you wish gung ho end-of-life treatment or simple palliative care.
Get it in writing. Make your wishes known while you are still able to do so.
And regarding [2], some states do have some modern forms of "debtors prison" [2a], at least for fines imposed through the legal system, although are not as overarching as debtors prisons were leading into the modern age.
I assign a utility score of negative infinity to my own death. If the outcome for no treatment is zero percent chance of survival, but the outcome for a treatment that costs some large finite amount C [1] and raises survival chance to epsilon percent chance of survival for some epsilon (nonzero but potentially small), then I would opt for C every time.
This means if there's a way I can convince people to spend a billion dollars to try to cure me, I'd do it. Even if there's a 99% chance I die anyway and it means all that money couldn't be used on a better project, even if successful treatment meant I was in debt to a billion dollars which I could never repay, so I became bankrupt and my entire family would go to debtors' prison for life [2], that's still better than being dead.
Even if I had to kill a healthy child with my bare hands and drink their blood for the treatment [3], I'd still do it even though this scenario results in net negative utility for the human race (one for-sure dead child and one living adult with a 99% chance of dying is clearly a worse outcome than one living child and one dead adult.) Because I'm not interested in the utility of the human race; I'm interested in maximizing my own utility (one percent chance of being alive is still infinitely better than zero percent chance of being alive).
So my advance directive would be "hold at all costs: Liquidate everything, put me through prolonged medical torture if you have to, but the top priority is to keep me alive at any price."
[1] In "costs," I include not just money but my own prolonged pain and suffering; emotional distress of family members; violation of ethical standards; etc.
[2] This hasn't been a real thing for over a hundred years. I guess the modern equivalent is spending your childrens' college fund.
[3] If you believe that life begins at conception, this is basically what stem cell treatment entails.