Death and End-of-Life Planning in One Midwestern Community

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Abstract
DESPITE the great attention given to death and dying in the medical, ethical, and legal literature in the United States, an incomplete picture remains of end-of-life planning and decision making. It is reported that nearly 80% of deaths occur in health care organizations and more specifically that 60% of deaths occur in hospitals.1 The findings of SUPPORT (Study to Understand Prognosis and Preference for Outcomes and Risks of Treatments) provide a picture of the treatment of critically ill patients with limited prognosis, but it does not provide a picture of end-of-life planning and decision making for the general population.2 The findings of the La Crosse Advance Directive Study (LADS) reported herein provide a more comprehensive, detailed look at death, end-of-life planning, and forgoing medical treatment in a geographically defined population.