The Time to Talk About Death Is Now

As a daughter, a physician, and a federal healthcare policy advisor, I have seen how easily death can be hidden away.

Almost exactly 20 years ago, my father was diagnosed with intestinal cancer.

After several unsuccessful rounds of chemotherapy and a week in the intensive care unit, it became clear that his time was short.

The experience was overwhelming.

Yet throughout it all, our family never sat down together to talk openly about what was happening.

It never seemed like the right time. Because the right time never arrived, the question of what the end of my father’s life would, should, or could look like slowly disappeared from view.

My father died in a hospital room, connected to lines and tubes.

I cannot help but wonder whether he would have wanted something different.

Why Don’t We Talk About Death?

Conversations about death tend to happen at one of two moments.

They happen with no sense of urgency because death still feels distant, or they happen after a sudden decline in health, when decisions must be made quickly and it may already be too late for a meaningful conversation.

We struggle with when to talk about death. We also struggle with how.

These conversations are difficult. They bring up fear, grief, vulnerability, and uncertainty.

As a result, many of us grow up without learning how to discuss death with adults or children.

And yet the data suggests that people think about their end-of-life wishes often.

A study from the Kaiser Family Foundation and The Economist found that nearly 80 percent of people had considered what they wanted near the end of life, but fewer than 20 percent had discussed those wishes with a healthcare provider.

Why does such a wide gap remain?

We Are Terrified of Death

Three forces shape the experience of death and dying in America: culture, medicine, and our systems of care.

Culture shapes how we think and feel about death. We fear talking about it, thinking about it, and losing to it.

Medicine is designed to prevent death and prolong life. It often falters when confronted with the one outcome it can never overcome.

Our healthcare systems care for people approaching the end of life, but they can unintentionally disregard individual values and oversimplify deeply personal choices.

We have to do better.

Death Is a Human Experience

Death is as human as it gets.

Every year in America, approximately 2.4 million people die. That is more than 1,600 people every day.

The aspects of death that frighten us most, including vulnerability, decline, meaning, and legacy, are also central to what it means to live.

What could change if we treated death as a human issue?

We could create a world where death is discussed openly, end-of-life wishes are known, care is individualized, and people have the opportunity to express what matters most to them.

Reaching that point will require deliberate change in our culture, our practice of medicine, and our systems of care.

The time to begin is now.

The time to talk about death is now.