Breaking the Silence: Terminally Ill Patients and the Modern Day Healthcare System

Throughout time, the unique journey of a terminally ill patient has been met with a variety of challenges within our modern-day healthcare system, which spans from the shock of an initial diagnosis to the point of death. Though death and dying are unavoidable experiences for the living, there remains a palpable element of “silence” surrounding several aspects of this passage from one stage to the next. The current healthcare system is designed to confront the multitude of diagnostic obstacles, often with the intention of curative measures, regardless of how futile these measures may be. A significant gap continues to exist between realistic, viable treatment options and the autonomy of a terminally ill patient.

It is imperative that physicians reevaluate current practices on life limiting diagnoses and how to compassionately steer the course with the terminally ill. The intensity of suffering is in many ways impacted by how healthcare practitioners approach the topic of death, or more importantly, how it is not addressed. Communication is paramount and serves as the consistent guide to navigate patients and families through uncharted territory and mitigate unnecessary anguish. This ranges from the “art of listening” to discussing advance planning and empowering the patient and family with a realistic understanding of next steps.

To facilitate a shift in this climate of “silence” and the current paradigm prevalent in the medical community, more comprehensive death education for physicians is undeniable. Decisions in the trajectory of care impact not only the terminal patient, but also the value in prescribed treatments from both an ethical and healthcare spending standpoint. Communication, advance planning, and costs of treatment are primary factors where open discussions must be rooted in compassion and reality to make “dying a good death” the standard of care for the terminally ill.

Learning Objectives

  • Discuss the importance of realistic communication between physicians and patients, with the delivery of a terminal diagnosis.

  • Explore the value in advance planning, for the terminally ill.

  • Examine how healthcare spending plays a role in the journey of the terminally ill patient.

  • Identify the current barriers that contribute to the “climate of silence”, surrounding death in the healthcare system.

Additional Information

Association for Death Education and Counseling (ADEC)
State Relevance: 
Oregon Requirement
Course summary
Available credit: 
  • 1.50 AMA PRA Category 1 Credit
  • 1.50 ANCC
  • 1.50 APA
Course opens: 
Course expires: 
Nonmember cost:
Member cost:

About the Presenter:

Dr. Kenneth Pettit has practiced as a Doctor of Osteopathic Medicine for over 20 years and is a member of the American Board of Family Physicians and the American Osteopathic Association. He is also board certified in family practice, a certified hospice medical director, and a wound care specialist. As a medical director, he has served in various disciplines ranging from inpatient palliative care programs and home health to skilled nursing facilities and wound care. He is currently the owner of Comprehensive Family Care and expanded his practice to include Comprehensive Hospice and Palliative Care in 2011, due to his desire to assist the those facing their mortality.

His passion for providing medical and supportive care to the terminally ill, prompted his desire to write and publish his first book in 2021 entitled “They Call Me Dr. Death.” Dr. Pettit’s candid and human-based assessment of the current gaps in the healthcare system are thought provoking and provide much needed insight into the journey of the terminally ill, as they navigate the healthcare system.

He has received several awards for his work, including “Top Doctor of Ahwatukee” and “Regional Medical Director of the Year.” Dr. Pettit lives and works in Arizona, where for recreation he enjoys riding Harleys, flying helicopters, and travel.

About the Moderator:

Melanie Wright graduated with her Bachelor of Art in non-confessional Religious Studies, with a leading focus on cross-cultural perspectives on death and religious impacts on human rights and bioethics. Following this, she journeyed to complete her Master of Social Work, where she developed the inaugural internship program between Arizona State University and the Mayo Clinic. During a two year graduate rotation with the Mayo Clinic, Melanie conducted a research study entitled, "Physicians’ Perspectives on Socio-Political Barriers to Effective Palliative Care in a Hospital Setting”, which she was then invited to present at the 2005 "Joint National Conference of the American Society on Aging and the National Council on Aging". This research contributed to the formation of an in-house hospital Palliative Care Team at the Mayo Clinic; the first program of its kind on a national scale. As a result, Melanie was presented with the distinction of "Honorary Member of the Mayo Clinic School of Health Sciences Alumni Association." Currently, she is the acting President for the Parkinson Network of Arizona, which funds all wellness/outreach programs for the Muhammad Ali Parkinson Center at Barrow Neurological Institute. She is an active member of the National Association of Social Workers, National Council on Aging, American Association of Integrated Healthcare Delivery Systems, Alliance for Professional Healthcare Advocates, and serves on the Advisory Council for the Arizona Interfaith Movement. Melanie obtained her Fellowship in Thanatology, with a focus on therapeutic interventions for the terminally ill and is actively conducting research on patient-centered care when confronted with a life limiting diagnosis. She is the acting Chair of the Professional Development Committee for the Association on Death Education & Counseling (ADEC).

This webinar is approved by the American Psychological Association (APA), the Association of Social Work Boards (ASWB), the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) for 1.5 CE hours.

Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by Amedco LLC and The Association for Death Education and Counseling. Amedco LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Amedco LLC designates this live and enduring material for a maximum of 1.50 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Amedco LLC designates this activity for a maximum of 1.50 ANCC contact hours.

Amedco LLC designates this activity for a maximum of 1.50 psychologist contact hours.

Social Workers
As a Jointly Accredited Organization, Amedco is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Amedco maintains responsibility for this course. Social workers completing this course receive 1.50 GENERAL continuing education credits.

New York Board for Social Workers
Amedco SW CPE is recognized by the New York State Education Department’s State Board for Social Work as an approved provider of continuing education for licensed social workers #0115. 1.50 hours.

Available Credit

  • 1.50 AMA PRA Category 1 Credit
  • 1.50 ANCC
  • 1.50 APA


Nonmember cost:
Member cost:
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This course is offered through the Association for Death Education and Counseling. 

To take this course you will be redirected to the Association for Death Education and Counseling's website. You must login or create an account with the Association for Death Education and Counseling in order to complete this activity. 

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Terminally Ill PatientsEnd-of-life Care