Today is National Healthcare Decisions Day and, with it, a discussion revolving around end of life care and decision making. The Institute of Medicine recently published a report entitled “Dying in America” and, according to its study, less than 30 percent of Americans have discussed their end of life preferences with family members or their physician. The focus on end of life is not meant to be morbid; there is importance in making people feel comfortable conversing not only about how we live but how we die. The IOM report recognizes that Americans are not well informed about end of life care choices, and that physicians often don’t tie those options into their patients’ overall care plans. Recommendations include educating patients and physicians alike in how to communicate with each other on this issue, providing them with information on palliative care, and standardizing the advance planning approach.