However, the federal standards set by Medicaid require the six-months terminal prognosis, and insurance providers may restrict access to hospice care to pediatric patients undergoing life-extending treatment.

HIV testing and diagnosis are the first steps toward connecting people to life-extending treatment, as well as helping to prevent the spread of HIV to partners.

Diagnosed with a terminal disease, he has decided to forego life-extending treatments so he can focus on learning what he feels he does not yet know about the world.

Like her two younger siblings who had died of the disease during the 1980s, she declined life-extending treatment.

Given clear and convincing evidence of the patient's choices, hospitals may forgo life-extending treatment without having to go to court.

However, an organ transplant may save the prison system substantial costs associated with dialysis and other life-extending treatments required by the prisoner with the failing organ.

Countries in which this pattern has been seen are evidence of the pitfalls of failing to adapt prevention efforts once life-extending treatment becomes widely available.

But surely most patients would rather get life-extending treatments than languish in neglect.

That ruling put new pressure on individuals to make known their wishes about life-extending treatment, in language far more specific than the familiar "I wouldn't want to live like a vegetable."

Andrew Wilson, Chief Executive of the Rarer Cancers Foundation, said: "We are concerned that nearly two hundred patients have been denied life-extending treatment, despite money going unspent."