Communication between health care providers,
patients, and patients’ families toward the end of
life is as challenging as it is necessary. As chronic diseases
progress and terminal diseases enter their final
stages, communication facilitates shared decision
making based on clear disclosure of information,
accurate understanding of that information, and
respectful and compassionate dialogue through
which clinicians, patients, and families seek to
integrate biological realities with profound human
needs for meaning, comfort, and direction. The need
for such communication is compelling, even as questions
may be raised about the limits to which
communication can improve the quality of end-oflife
care,and notwithstanding the complexity and
challenge of decision making as prospects for life
diminish