I don't think it's so much that we kill people. It's that we let them die. If we are truly, brutally honest with ourselves (and overcoming denial, social, religious, whatever conditioning here is a huge struggle), much of the time, the efforts we put in to keeping loved ones alive is really often more about us than it is about them.

The elderly (and I'm generalizing, I realize) are far more accepting of death. It's easier to accept that when you feel you have lived a full and happy life. Contrarily, that full and happy life often involves having the presence of loved ones, who are NOT ready to accept that their life will be - or rather, will feel - less full and happy without that person.

Even just simple denial is a huge thing. One of my first experiences in emergency medicine was an older gentleman, family patriarch. The rest of his extended family had been able to gather at the hospital while he was in and out of arrest.

A provider and support person went to talk to the extended family, who was adamant about following his son, the 'number two patriarch', and his steadfast insistence, "He is a good strong Christian man, and he is going to be okay." (I say this not to mock Christians, to be clear, and also to be clear, he didn't mean in the "eternal life" sense, he and the family truly believed almost that divine intervention was going to take care of things).

After some discussion on this, a decision was made to bring the son into the ER where we were working on his father. Seeing the hopelessness and futility, seeing his father the shadow of the man he knew, and all of that assorted detail was no doubt traumatic, but it also made it viscerally real to his son. No matter the concerted efforts of nearly 10 medical professionals, drugs, defibrillation, ventilation, we were not going to be able to keep his father alive, and there was not going to be any divine intervention. He watched this silently for a few moments, and then asked us to discontinue CPR and if his father's organs were suitable for donation.

My heart broke for him. But this is a struggle we have not figured out, recently. We had it figured out, historically, by necessity, but we are complacent now.

Leaving aside the separate issue of healthcare costs, you can still look at the ratios:

In the US, on average we spend more on healthcare keeping someone alive for the last year of their life than we do on the previous decade. And we spend more on that decade than we do on the rest of their life. Some of which seems obvious, given youth, but nonetheless.