The One Question That Determines Your Good Death
Psychology Today
by Suzanne B. O’Brien RNFebruary 25, 2026
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The One Question That Determines Your Good Death: A Call for Clarity
A poignant story from an oncology nurse highlights the importance of defining quality of life in end-of-life care. When a patient's wishes are unclear, families and medical teams often default to aggressive interventions, even when they may not align with the patient's true desires. This scenario is not due to lack of love or skill but rather the absence of clear communication about what matters most to the individual. The crux of the matter lies in asking one critical question: What does quality of life mean to you, and when would it no longer be acceptable?
Modern medicine often prioritizes treatment and intervention over clear goals, especially during moments of crisis. Families under stress face "decision conflict," leading to choices that may not reflect the patient's values. Without predefined benchmarks, decisions are left to fear-driven instincts, often resulting in unplanned medical escalation. This can cause unnecessary trauma for both patients and families, as well as long-term emotional consequences for surrogates forced to make high-stakes decisions without guidance.
Research consistently shows that advance care planning reduces stress and improves alignment with patient values. When individuals define their quality-of-life thresholds, care can shift from prolongation at all costs to comfort-focused approaches. This clarity allows families to navigate difficult choices with confidence, minimizing regret and aligning care with the person's wishes. Early conversations about goals of care are linked to better quality of life and even longer survival in some cases compared to late-stage interventions.
Culturally, death is often viewed as a failure rather than a natural part of life. Many avoid discussing limits out of fear it will diminish hope. However, evidence suggests the opposite: early planning fosters hope by ensuring care aligns with what truly matters to the patient. This approach not only reduces medical burden but also promotes peace and dignity in the final stages of life. By embracing these conversations, we can transform end-of-life care into a process that honors individual values and brings comfort to both patients and families.
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Originally published on Psychology Today on 2/25/2026