first of all you're a professor at harvard medical school and chief of experimental medicine at beth israel deaconess medical centre. you are a new york staff writer and you have a new book called "your medical mind: how to decide what is right for you" so are you saying that i get to decide on my treatment? >> i-- why did you go to medical school. >> i went to medical school to help you understand the risks and benefits as an individual are. so you can put your values into the decision. >> stephen: but i come to you. i'm sick. and by the way did you bring your prescription pad tonight. did you bring anything like that. because i hear there is a cough syrup with vicodin that whatever you need for that, i've got that. >> jeff toobin will represent me. >> stephen: fantastic. but if i'm a deathly sick person, do i want to you take over to tell me what's best for me? because i'm dealing with the stress of being a terribleably sick person. >> i can help certainly guide you and explain to you what the risks and benefits are. but i need to know from you what your personal approach is. what your ph

lachlan forrow is director of ethics and palliative care at beth israel deaconess hospital in boston. >> the tragedy is our health care system does not provide any context to help doctors and nurses have the time to talk with people about these hard things, and the whole system is greased to pay hospitals and others for expensive things people might not even want. one of the fundamental problems is what gets called our fee-for-service system. doctors and hospitals get paid for the things that they do that tend to be expensive. the more expensive it is, the more you get paid. >> our medical system can't keep everyone healthy, but it excels at keeping people alive, which is expensive. 25% of all medicare spending is for the 10% of patients who are in their final year of life. for the year 2012 alone, that's expected to be $137 billion. most of the money is spent in the last six months of life, which is often of little benefit, if any, to the patient. and the conversations between patients and doctors and family members which might make a difference, dr. forrow says, aren't happening, pa