Can a patient-to-doctor letter communicate end of life wishes better than a traditional advance directive?

Ilana Yurkiewicz


Many patients lack advance care planning and unfortunately spend their last days in ways not concordant with their values. This work assessed the use of a “What Matters Most” letter in gleaning hospitalized patients’ end-of-life wishes, priorities, and goals. We found that patients were receptive to completing the letter in lieu of a traditional directive, and the majority hoped the letter be used to guide their families. The patient-to-doctor letter may offer a more holistic picture of patients’ values, family dynamics, and cultural backgrounds that can help providers honor end-of-life wishes with care and respect.
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