Increasingly available medical interventions result in a longer process of living and dying with debilitating and progressive illness. Where living ends and dying begins is a liminal threshold. In short, dying includes a diverse and poorly understood phenomenon characterized by a steady generalized shutdown, trailed by a failure to thrive, and ultimately concluding with death. The role of palliative and hospice care becomes more exigent with each technological advancement; populations receiving the benefit of medical advancement similarly require the comfort of hospice and palliative care. Communicating about treatment and care planning near death is of prime importance, but can also be the most challenging communication a patient and family will encounter in their lives. Family conflict is highest surrounding difficult health decisions. The most demanding ...