The Limits to What Medicine Can Do: The Importance of End-of-Life Planning and Care

Planning for one’s death or the death of a loved one is an exceedingly difficult and painful task. However, it’s hard to deny the importance of such a task for the peace of mind of the patient, their family, their doctor, and even their legal representation. Currently the reality of preparedness for end-of-life planning and care versus individuals’ wishes are not matching up. How so? Read on to find out and learn how best to solve this problem.


The facts

Here are some important statistics that demonstrate the dissonance between desires and actions taken by Americans in regards to end-of-life planning and care:

  • A Kaiser Family Foundation/Economist survey found that half of Americans say they have too little control over their end-of-life medical decisions.[1]
  • One study of Californians found that 80% of respondents would want to talk to their doctors about end-of-life care if seriously ill, and yet only 7% report having an end-of-life conversation with their doctor.[2]
  • 90% of Californians have deemed talking about end-of-life care with loved ones important, yet only 27% have actually done so.[3]
  • 82% of Californians believe that it’s important to put their wishes in writing, yet 23% have actually done it.[4]
  • The Kaiser Family Foundation reports that 54% of Americans say it is “extremely important” to them that their family is not financially burdened by their end-of-life care.[5]
  • One study found that only 25% of physicians were aware of advanced directives made by their patients.[6]


Advice and important actions to take

As made clear by the above statistics, people want their families and physicians to know what they want when the time comes to say goodbye, but are clearly struggling to find the courage or lack the knowledge to communicate these desires. If our wishes to remove financial and emotional burden are to be realized, and if our end-of-life care is to be carried out as we want it to be, it is critical that the following steps are taken:


  • Have the tough conversations. While it isn’t easy, it is critical to express to your loved ones and physicians your wishes for end-of-life care. One resource to help facilitate this process is the Conversation Project.
  • Write down your wishes. Beyond talking directly with those involved with your end-of-life care, writing a will, updating estate planning documents, and establishing a durable power of attorney will help provide peace of mind for you and clear directions for those around you.[7]
  • Chose a healthcare proxy. It’s extremely important to name a trusted person to make health care decisions for you if you should ever become unable to speak for yourself. Beyond trust, though, it’s also good to name someone emotionally strong enough to advocate your wishes under the pressure of doctors and other loved ones.[8]
  • Don’t get overwhelmed. It’s easy to find yourself considering the details of millions of potential scenarios resulting in your eventual death. However, focusing on the big picture can help you to answer the most important questions first, and allow you to work backwards from there.[9]
  • Update your end-of-life preferences over time. Revisit your advance directives at least every five years so as to insure that they reflect new health challenges you’ve encountered and relationships that may have changed.[10]
  • Don’t put it off. It’s never too early to plan for death. Making difficult decisions during a crisis situation is far more difficult, and some preferences, such as avoiding CPR, are not always possible if they’re not in writing before an emergency occurs.[11]


Though it may seem morbid, planning your end-of-life care can be extremely empowering and stress-reducing. Knowing that measures are in place now can critically help everyone in the long run.

[1] Powell, Robert, “Don’t wait: Now’s the time to discuss end-of-life care,” USA Today, May 23, 2017,–life-care/101425830/

[2] Lake Research Partners and the Coalition for Compassionate Care of California, “Final Chapter: Californians’ Attitudes and Experiences with Death and Dying,” California Health Care Foundation, Feb. 2012,

[3] Ibid

[4] Ibid

[5] Powell, “Don’t wait”

[6] Tillyard, Andrew RJ, “Ethics review: ‘Living wills’ and intensive care – an overview of the American experience,” Critical Care, July 11, 2007,

[7] Powell, “Don’t wait”

[8] Wyatt. Karen M., “6 Mistakes to Avoid When Doing Your End-of-Life Planning,” Huffington Post, April 13, 2017,

[9] Ibid


[11] Ibid