May 22, 2014 | Posted By Jane Jankowski, DPS

The seventh annual National Healthcare Decisions Day (NHDD) was held on April 16th of this year, and events at national, state and local levels were held to educate people about the importance of advance care planning and encourage participants to complete advance directives. Providing resources and information that drives home the message about how important it is to let others know one’s preferences for healthcare and end of life care is intended to promote conversation and documentation of these wishes which are then implemented when the individual is no longer able to express preferences for themselves. But does it do enough to generate interest in those who prefer to avoid such unpleasantries?

Repeated studies show that advance directive completion rates are low in the US. People simply do not like to talk about end of life, and it is not clear that the NHDD, however well intended, is making the topic any more palatable. Designating a day to recognize the importance of advance directives is an important start, and the materials are often excellent. Five wishes, for example, gives a carefully crafted set of questions to help people thoughtfully consider what matters most to them when it comes to medical intervention, particularly in the end of life context. Still, this only works if people come to the table for the conversation.

While fear-mongering is not a tactic I generally endorse, a dose of reality may be useful to help people understand what can happen to themselves and to loved ones when the conversation never happens and tough decisions need to be made.  Let’s add to the conversation by helping families who have been faced with difficult medical decisions share these stories in order to help others avoid similar experiences. There is no better education than reality, and helping others is often healing for those who are able to tell their own story.  I would encourage participants organizing NHDD events for 2015 to add these voices to the forum and perhaps reach new audiences thereby enhancing the overall impact of these efforts. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

1 comments | Topics: Advance Directives , End of Life Care , Living Will


A-1 Home Care

A-1 Home Care wrote on 09/24/14 5:47 PM

An alternative way may be to start asking families who have already lived through this experience to share their personal stories with friends. As the article suggested, most people will not go out of their way to listen to speakers talk about a topic that seems far off in the future. The general public may be more receptive to hearing their friends talk about it over dinner than to attend an event.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.