Monthly Archives: July 2013

Paula Span’s A Novel Way to Document End-of-Life Preferences

Although I haven’t yet had a chance to read Dr. Lakin’s research study from JAMA referenced in this article (but I certainly plan to!), this summary from Paula Span provides food for thought.paulaspan

Here is a comment I posted, but is still waiting for approval from  But here it is in the meantime:

Thank you Ms. Span for another article on the extremely important topic of advance care planning. I work in the ICU and in my experience, very few patients have documented end of life preferences when they arrive in the ICU despite having chronic or even end stage diseases for many many years. This has to change!

Paula Span,, The New Old Age

Although I haven’t yet read Dr. Lakin’s research study, it strikes me that it’s not important not only to encourage doctors to document an end of life care plan, but also to make sure that it is accurate and not simply a default, which is often “do everything”.

There are some great resources out there for patients and families to use to embark on these difficult conversations. Personal stories are a wonderful way to get information, and the work that the Conversation Project does is excellent. Also, the Last Wish Compass ( is a brief discussion guide that helps patients consider important issues to communicate with their families and doctors. Dr. Lakin’s work is exciting in that it suggests increased awareness does make a difference.

-Lauren VanScoy, MD


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“Everyone on Medicare should have their end-of-life preferences clearly spelled out…”

Here is a nice piece from Ezra Klein in the Washington Post called “Can we please talk about death like adults?” with a great ending statement:

“And so seniors living out their final days get tortured by the medical system because everyone involved was too afraid to talk about death — and the occasional ugly realities of end-of-life “care” — before it was near.”

Read the full article here:


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