Like many other cultures, Australian Aboriginals believe death serves as a transition from one plane of existence to another, one not much different from life on earth. On Goulbourn Island in the Arafura Sea of Australia’s Northern Territory, the dead are put to rest on a rocky platform for an eternal wake, while the living continue to visit to commune. Elsewhere on the continent, the modern population of Australians — white, Aboriginal, Asian, South American — spend nearly a quarter of the national health budget on futile end-of-life care, prolonging the deathly transition not unlike the islanders on Goulbourn.

Although 90 percent of Australians with advanced terminal diseases tell researchers they’d prefer to die at home, such patients — left most often to the care of junior doctors lacking decisive authority — will make eight hospital visits on average during the final year of life, with a 60-70 percent chance of dying on a ward.

Now, some Australian doctors say the nation’s medical system should empower doctors and their patients to avoid “conveyor belt” emergency care deemed “reactive, unwanted, and unnecessary,” in a paper to be released Thursday from the Australian Centre for Health Research, Monash, and Melbourne Universities.

And, in a paper published last week by the Medical Journal of Australia, doctors describe how some patients stayed at home for a dignified life ending, with the help of palliative care from a religious organization. Allison Sheather, 48, wished to spend as much time as possible at home with her two children while she endured the final stages of deadly breast cancer. With the help of her doctor, and palliative care nurses, she makes only occasional forays into a clinical setting.

“For me personally there is no going back," she says. "I'm only 48 and it's a big decision. I've spoken to my doctors and my family and that's how it's come about listening to them. It's hard as you can imagine.”

However, she added that she spent the day going out for groceries, rather than languishing in a hospital bed.

Regarding unnecessarily expenditures by the national health system, Paul Myles, an anesthetist and medical professor in Melbourne, describes a typical end-of-life healthcare episode that might have been avoided for the good of all.

A septuagenarian is rushed to the emergency room for “life-saving” surgery spanning nine hours. Aside from the expense on manpower, the operation cost 20 units of blood and forced the postponements of three surgeries, for much younger patients. The old man — barely ambulatory with poor memory, his kidneys shot — died in the intensive care unit 13 days later.

"I could not see how he would ever have an acceptable quality of life," Myles said.

Yet, Australia’s medical system continues to mismanage the end-game of life, even as half of all deaths come from advanced disease with predictable endings, giving doctors and patients a chance to avoid unwarranted care, according to Ian Scott, a medical professor writing in the same journal.

"Almost a quarter of intensive care beds are occupied by patients receiving potentially inappropriate care," he said. "Regrettably considerable suffering as well as dissatisfaction with and overuse of health care result.”

Moreover, researchers in Australia find a medical culture reluctant to let go of life-prolonging treatment for the dying, even when patients have signed non-resuscitation orders, a long way from the dead of Goulbourn Island.