Preparing for Death: Which question should the care team ask when preparing for death?

• A. Can we introduce new experimental therapies regardless of patient wishes?
• B. How does the patient feel about the current treatment plan and whether to continue or stop treatment?
• C. Can the patient become a marathon runner?
• D. What are the patient's dietary preferences for hospital meals?

Answer: (B)

Preparing for death means aligning the plan of care with the patient’s goals and values through open, ongoing conversations about what they want as their prognosis changes. The best question asks how the patient feels about the current treatment plan and whether to continue or stop treatment. This directly engages the patient in decisions about the course of care, respects autonomy, and helps move toward goals that maximize comfort and quality of life. It also sets up a clear path for transitions to comfort-focused care or hospice if that aligns with the patient’s wishes.

Context: in end-of-life care, clinicians explain the benefits and burdens of continuing aggressive therapies, assess decision-making capacity, and involve the patient (and family or a surrogate when needed) in shifting goals as needed. While dietary preferences or other aspects of care can be relevant to comfort, they don’t address the core need to understand and document the patient’s treatment preferences and goals as death approaches.