To conclude this CitiZing project and the in-person listening sessions that the Citizens League has hosted on behalf of Honoring Choices Minnesota, we are summarizing what we have found about what helps people plan for difficult end-of-life choices -- and what the obstacles can be. We will be presenting this in a report to the Twin Cities Medical Society at the end of the month.

Before we finalize the report, we want to get your feedback. Do you agree with the findings? Do you disagree with anything we have said here? Are we missing something big? Please let us know.

You can...

At a recent Honoring Choices discussion, a young mother started tearing up. Tears were nothing unusual for these conversations—it’s a very emotional subject. But Lindsey has two young children, and parents in good health. She has never been in situations requiring life or death medical decisions. Her emotions were simply her response to the stories of others in the group who have dealt with the death of a loved one.

Lindsey was a little nonplussed by her emotions. “Oh, I’m crying and I’ve never even had anyone die,” she said. But there was so much beauty in this moment. Her reaction...

In the in-person listening sessions we've hosted, the Twin Cities Medical Society has asked us to pay special attention to how the medical community can best support families in end-of-life care and planning.

In separate sessions, two people had almost identical comments that really struck me. Both had been caretakers for loved ones at the end of their lives. They said that one of the best things medical professionals did was to give them permission to not do it all. Their stories have stuck with me:

One woman was caring for her husband, who had Alzheimer's at an early age. One day,...

TPT has now launched its new website: www.honoringchoices.org. Here, you will be able to find video clips from all of the listening sessions (many are up now, and more will be uploaded soon) as well as many other resources. Check it out!

End-of-life decision making: a cross-national study, by Robert H. Blank and Janna C. Merrick, contains a series of articles examining end-of-life practices and values in different countries. It notes that values dominant in the West, such as individual rights, lifestyle choices and a reliance on technology to fix all problems, are not universal across the world. I wondered if these values are a major source of the extraordinarily high medical costs in the U.S. compared to other countries. But the costs also seem to depend heavily on the availability of medical facilities.

The Dartmouth Atlas study, which looks at end-of-life care,...

Last night we had another great listening session.  As usual, I learned many important things.

Perhaps the most surprising discussion concerned the care provided by doctors. I asked the participants if, in their experience, they wished doctors had done anything differently.  Yes, they said.  “Don’t push so many treatments on us.  If we’re dying, let us die.”

The participants were not angry with or hostile towards doctors.  To the contrary, they were quite sympathetic.  They felt that doctors are taught to “save people” from dying, even though dying is inevitable and perhaps even imminent.  The need to “save...

What I cherish about the Honoring Choices focus group discussions is that it doesn’t matter what participants walk in with. All of us always walk out enriched. Whether participants have extensive experiences with making end of life choices or none at all, there are always visible moments of miniature epiphanies, when someone realizes something new and important.

In some of the focus groups, nearly everyone has an advanced care directive. Given that they’ve obviously thought about the matter, I ask why they wanted to participate in the focus group. They typical response starts with the far away look of self-reflection as...

Most of us don’t talk about death or dying.  We fear dying, so we also fear talking about it.  In fact, some of the people in our focus groups know friends or loved ones who won’t talk about death because they’re afraid that talking about it might make it happen.

But I’ve learned something very powerful from our focus group participants.  Finding the courage to talk about dying actually alleviates the fear.  People describe their conversations using words like “liberating” and “empowering.” 

I am a black belt in tae kwon do.  Progress from belt to belt requires breaking boards at each step...

In addition to engaging people online here, part of the Citizens League's work with Honoring Choices is to get people together in a series of listening sessions to explore these questions in conversation.

A pastor joined us at a recent session. He shared many insights, but one in particular really stuck with me, so I thought I'd share it here.

It is not just an individual who is going through the illness, death and dying process, the pastor said; it’s that person’s family and friends as well. In the best cases, the medical community cares not just for the person...