We must take steps to gain control over how we die

FELICE J. FREYER’S article “Wish to die at home often goes unmet” (Page A1, Nov. 3), describing how many Massachusetts citizens end up dying in the hospital, points out the troubling disconnect between how people wish to live their last days and how they actually do.

When surveyed, 70 percent of Americans, including doctors and nurses, say that they want to spend the end of their lives at home, surrounded by their loved ones. But too often these wishes are not expressed with family members or shared with health care providers. As Drs. Atul Gawande and Lachlan Forrow rightly point out, the medical culture in our Commonwealth too often medicalizes the human experience of dying.

The important first step in changing this culture is to engage our families in sharing their wishes for end-of-life care around the kitchen table before there is a crisis. To this end, we offer a starter kit to begin these hard conversations.

We are learning that we all need to share our values, to say what matters to us most at the end of life, and to confront the fear of both too much or too little treatment. These conversations are at the heart of enabling all of our loved ones to die in the way they choose.

Harriet S. Warshaw

Executive director

The Conversation Project

Cambridge