Yes, certainly people in medicine are aware.

> we let a 90 yr old with dementia/diatebetes/etc. pass with dignity.

Often it's a 4 week old baby.

For every 1 sophisticated family member, there are 19 unsophisticated ones, who toss a weighted coin and, if it's heads, they decide they want their dying, non-responsive relative - possibly their baby, possibly their mom, etc. - to be kept alive at all costs. I don't know if this is politically toxic as much as it is cultural, and possibly globally cultural.