5 Questions to Ask at End-of-Life
From an article by Hospice Care of the Lowcountry, SC, USA, citing Dr. Atul Gawande’s book, Being Mortal, summarized by Margaret Verschuur.
Facing the end of life is never easy, but asking the right questions can bring clarity, comfort, and a sense of control during one of life’s most uncertain chapters. A growing movement in healthcare is shifting the focus from simply extending life to ensuring that the life remaining is lived in alignment with personal values and goals.
Dr. Atul Gawande, a surgeon and public health researcher, has been a key voice in this shift. In his influential book Being Mortal, and through his work at Ariadne Labs, he has introduced a framework of five essential questions to guide end-of-life conversations. These questions are designed to move the focus away from just medical treatments and toward what truly matters most to each individual.
The five questions are:
- What is your understanding of where you are and of your illness?
- What are your fears or worries for the future?
- What are your goals and priorities?
- What outcomes are unacceptable to you? What are you willing to sacrifice—and not?
- What would a good day look like?
These questions encourage thoughtful, ongoing conversations—not just at the time of a medical crisis, but early enough to shape care that is consistent with the patient’s values. As Dr. Gawande has emphasized, asking these questions allows everyone involved—patients, families, and clinicians—to understand what the person is really fighting for.
This approach doesn’t suggest that people give up on treatment or hope. Instead, it offers a way to ensure that the choices made along the way support what’s most important to the individual, whether that’s more time, more comfort, or more meaningful moments with loved ones. Even choices that may seem unconventional—like indulging in small pleasures or declining aggressive treatments—can be completely valid when weighed against the person’s definition of a good day.
While healthcare often focuses on safety and longevity, Dr. Gawande points out that questions about connection, joy, and personal dignity are just as critical. Sometimes, honoring someone’s wishes means saying “yes” to something that may not be medically ideal but deeply meaningful to them. That, too, is living well.
It’s normal to meet some resistance when beginning these conversations. Talking about mortality can be uncomfortable, and people may initially avoid the topic. But even if the conversation is brief or tentative, it plants a seed. It opens the door to deeper understanding later—when the need becomes more pressing, or when the person feels ready to share more.
The most important thing is to start. By asking these five questions, inspired by Dr. Atul Gawande’s work, we create space for compassion, clarity, and peace in the most human moments of life.