To the Editor.
—The SUPPORT project1 seems to place the blame for the demonstrated breakdown in communication between physicians and patients squarely on the caregiver. Is this fair? I have spent much of the last 20 years working to empower people to take control of how they are cared for at the end of life. In so doing, I have met many caring nurses and physicians and seen the situations with which they are faced. If I were a physician in a hospital setting, I would hesitate to initiate the subject of end-of-life care if I had never communicated on such a difficult issue with the patient at an earlier time in a less-threatening setting. We must devise the means to make end-of-life care easier to broach. I suggest that when a patient arrives for an appointment with his or her physician, the patient can be asked to fill
Strong MS. The SUPPORT Project and Improving Care for Seriously III Patients. JAMA. 1996;275(16):1231-1232. doi:10.1001/jama.1996.03530400015028