Educating our Patients about Life and the End of Life: Toward a Pedagogy of Dying

There is an extensive literature on how physicians can best educate their patients about living healthier-one might call it a "pedagogy of living." In this essay, I suggests that physicians develop a "pedagogy of dying" for their adult patients: educating them about how they can approach death with some measure of grace and dignity, as consistent with their wants as possible, and cognizant of the final reality we all face. This process happens in the ambulatory settings as part of ongoing care and precedes any serious illness or the crisis of hospitalization. I draws on known models for communicating effectively, my own practice experience, and the disciplines of palliative care and bioethics in asking physicians to consider developing such a "pedagogy of dying," a kind of anticipatory guidance toward aging, infirmity, and, ultimately, death.