In the past, there was a limit to the expenses, which could be incurred by medical treatment of people needing medical attention. Usually the requisite know-how ran out before money. In other words, people died when their physicians no longer knew what to do.
Nowadays, there are more and more cases, in which the constraint is monetary rather than know-how. In other words, there are more and more cases, in which patients die not because physicians do not know how to treat them, but because money is not available to pay for known treatments.
Another factor, which did not exist in the past, is the ability of technology to keep the bodies of brain-dead people alive, by means of intravenous feeding and heart-lung machines. Such a treatment, of course, costs a lot of money, and could last for several years.
This change leads to an ethical dilemma, which did not exist in the past.
In the past, families could commit to treating a sick family member at any expense, and have reasonable expectation that he’ll either get well or die before the entire family is driven into abject poverty.
Nowadays, families are more and more confronted with the dilemma when to stop financing treatment of a sick family member. The sick family member could be elderly, needing care due to an age-related malaise. Or he could be a young child with congenital deformity or childhood cancer.
Another aspect of the dilemma is how to allocate financial means among family members, usually elderly, who need to be taken care of – and other family members, usually young, who need money for tuition, downpayment on dwelling place, and other expenses which will help get them ahead in their lives.