Values Clarification, Advocacy

The End-of-Life Conversation

The End-of-Life Conversation is a Values Clarification and Advocacy scenario. The core lesson: Why naming end-of-life wishes early changes every decision that follows. An older relative has been diagnosed with a serious illness. The prognosis is 6-18 months. DecisionPlay maps the players, payoffs, and equilibrium dynamics that shape how this situation typically resolves.

The situation

An older relative has been diagnosed with a serious illness. The prognosis is 6-18 months. They haven't talked about their end-of-life wishes. You're the closest family member and the likely decision-maker.

Background

End-of-life conversations are among the most avoided and most consequential conversations a family can have. People who study them keep finding the same pattern: it is the families who have talked explicitly about wishes who are spared the worst of the conflict and the guessing. The avoidance doesn't protect anyone, it just defers the decisions to a moment of crisis.

What this reveals

The avoidance cost of mortality conversations

End-of-life conversations are avoided because they feel unkind. The pattern in the research points the opposite way: the families who have them are the ones spared the worst of the conflict and the lasting doubt. The avoidance protects no one, it just defers the decisions to a moment of crisis when no one is equipped to make them well.

How to counter it: The conversation doesn't have to be long or formal. It starts with one question: 'If things got bad, what would matter most to you?' Most people who are given genuine permission to answer that question are grateful for the chance.

A question to sit with

What conversations about mortality are you avoiding with the people closest to you? What would it cost you to start one this month?

Frequently asked questions

What game theory concept does The End-of-Life Conversation illustrate?
The End-of-Life Conversation illustrates Values Clarification, Advocacy. Why naming end-of-life wishes early changes every decision that follows.
What is the situation in The End-of-Life Conversation?
An older relative has been diagnosed with a serious illness. The prognosis is 6-18 months. They haven't talked about their end-of-life wishes.
What does The End-of-Life Conversation reveal about how people decide?
The avoidance cost of mortality conversations. End-of-life conversations are avoided because they feel unkind. The pattern in the research points the opposite way: the families who have them are the ones spared the worst of the conflict and the lasting doubt. The avoidance protects no one, it just defers the decisions to a moment of crisis when no one is equipped to make them well.
How do you avoid the trap in The End-of-Life Conversation?
The conversation doesn't have to be long or formal. It starts with one question: 'If things got bad, what would matter most to you?' Most people who are given genuine permission to answer that question are grateful for the chance.
What is the research behind The End-of-Life Conversation?
End-of-life conversations are among the most avoided and most consequential conversations a family can have. People who study them keep finding the same pattern: it is the families who have talked explicitly about wishes who are spared the worst of the conflict and the guessing. The avoidance doesn't protect anyone, it just defers the decisions to a moment of crisis.
How long does The End-of-Life Conversation take to play?
About 12 min, at advanced difficulty, across 4 decision points. It runs in your browser with no account and no sign-in.

Keep exploring

More Personal Decisions scenarios, or browse all scenarios. New to this? Start with how DecisionPlay works or the game theory glossary.

Topics: end-of-life, values, advocacy, mortality