The popular media that people consume, including television shows, can influence their end-of-life decision making.
This is according to new research from End Well, a nonprofit dedicated to the belief that all people should experience the end of life in a way that matches their values and goals. The study examines whether pop culture storylines that involve death and dying influence viewers’ behavior when it comes to advance care planning.
Viewers of the end-of-life storylines were significantly more likely to take action than those in a control group. They were more likely to initiate conversations about the end-of-life, seek more information about options and planning and share locations of legal and financial documents. They also were more likely to discuss care preferences with loved ones, draft or update advance directives and help aging parents with decluttering and planning.
Other research has shown that advance care planning can boost hospice utilization. However, even though 90% of people in the United States say end-of-life conversations are important, only 27% have actually had them, according to End Well.
Hospice News spoke with End Well Founder and Board President Dr. Shoshanna Ungerleider about the research and how popular media can influence end-of-life choices.
Why is end-of-life planning so crucial?
End-of-life planning is crucial because it’s about preserving dignity and ensuring that care aligns with what matters most to each person. As a physician, I’ve sat with too many families making agonizing decisions in hospital hallways without knowing what their loved one would have wanted.
But beyond crisis prevention, planning for the end of life is really about planning for how we want to live. When we clarify our values, what gives our life meaning, what dignity looks like for us, and who we trust, we’re creating a framework for living more intentionally every day. This is exactly why we founded End Well: to normalize these conversations so they happen long before crisis hits, when people have time to reflect deeply on what truly matters.
Do you think that more exploration of death is occurring in pop culture these days? What do you think is contributing to that?
Yes, I believe we’re seeing a real shift in how pop culture approaches death, dying and grief. For a long time, death was treated as a failure, something to hide away in hospitals and institutions. But every day, thousands of people die in the U.S., and nearly everyone will be touched by caregiving or loss at some point. That’s a huge part of the human experience that our culture has largely ignored.
Now, audiences are craving honesty. We’re seeing more shows, films, and podcasts willing to explore the complexity of these experiences — not just the tragedy, but the love, humor, and meaning that can coexist alongside it. Projects like The Pitt, A Million Little Things, Dying for Sex, The Gentle Art of Swedish Death Cleaning and many others are helping people see death as part of life, not separate from it.
At End Well, we believe this cultural moment matters deeply. Our research with USC’s Norman Lear Center shows that when people see authentic depictions of illness, dying, or caregiving on screen, they don’t just feel seen — they take action. They start conversations, make plans, and approach the topic with less fear. That’s the power of storytelling.
And to some degree, we’ve been intentional about helping shape that shift. From the beginning, End Well has brought public figures — people like Tig Notaro, Taraji P. Henson, Maria Shriver, Melissa Etheridge and Tim McGraw. Along with clinicians like Dr. Atul Gawande, Dr. B.J. Miller and Esther Perel, onto our stage to share their personal experiences with loss and caregiving. When familiar, trusted voices speak openly about something so universal, it gives the rest of us permission to do the same.
In many ways, culture is finally catching up to what End Well has been working toward all along: normalizing conversations about mortality so that we can all live, and die, a little more fully.
How are the programs you cited in the research approaching the topic of death? Are there any common threads?
The programs we studied, A Million Little Things and The Gentle Art of Swedish Death Cleaning, approach death through several common threads that make them particularly resonant. They ground their stories in emotional realism with authentic portrayals of grief, love, and the messy, complicated dynamics that surface when families face mortality together.
They also incorporate humor and warmth. As The Gentle Art of Swedish Death Cleaning demonstrates beautifully, life’s funny moments don’t stop during serious illness. Humor often becomes heightened when we’re most attuned to what matters. This makes difficult topics more accessible and human.
They show supportive communities rallying around difficult decisions. Whether it’s Gary’s friends in A Million Little Things or Shana’s network in Swedish Death Cleaning, viewers see models of compassionate caregiving and witness how to show up for someone at the end of life.
The most effective portrayals are grounded in expertise. When shows consult with physicians, palliative care specialists, and people who’ve lived these experiences, audiences really recognize the authenticity.
How can health care providers leverage stories like these into their own ACP outreach or processes?
Health care providers can use these stories as entry points for conversations that patients often find difficult to initiate. When a patient mentions watching one of these shows, providers can reference it naturally: “Did you happen to see that episode about advance directives? It got me thinking, have you had a chance to consider what would be important to you?”
Health care systems can integrate these stories into patient education by offering simple viewing guides or discussion prompts tied to specific episodes. These tools can help patients process what they’ve seen and begin reflecting on their own values and priorities. When staff notice that a show or film has sparked curiosity or readiness to talk, they can gently build on that moment — perhaps by suggesting a palliative care consultation, sharing advance care planning resources, or simply opening space for conversation. Even small, authentic interactions like these can make a lasting difference.
The key is meeting people where they are. Television reaches audiences who might never read a pamphlet about advance care planning, but who will deeply connect with a character’s journey on screen.
Are these shows fostering greater initiation of these conversations by the health care provider, the patients and families, or both?
We’re excited to see these shows having an impact on providers as well as patients and their families which is exactly what we want and need. Our research demonstrates that viewers are significantly more likely to initiate conversations with loved ones, seek information and take concrete planning steps after watching end-of-life storylines. They’re discussing care preferences, drafting advance directives, sharing locations of important documents and having the values-based conversations that are so crucial.
We have a wonderful anecdote from The Pitt’s executive producer and writer Dr. Joe Sachs that: “Six weeks after the episode aired, an emergency doctor posted in a group chat on a social media site, saying, ‘I was working a night shift in the ER at two in the morning and a 92-year-old woman with a heart attack came in and was not doing well. The family said, You know, doctor, you can stop right there. We’ve been watching The Pitt and we’ve seen how much suffering can be caused by resuscitation efforts when there’s no meaningful hope, and we would just like to have comfort care.’”
For health care providers, these shows create natural openings for dialogue. When a patient mentions watching one of these programs or asks questions sparked by what they’ve seen, they’re signaling readiness to talk. Providers can use this shared cultural reference point to start conversations that might otherwise feel premature or uncomfortable.
The challenge is that most physicians weren’t trained for this. Medical schools spend years teaching us how to keep people alive, but just hours on how to talk about prognosis and goals of care. Through End Well’s educational initiatives, we’re working to change that: to ensure clinicians have the communication skills they need when patients express readiness, whether that comes from personal experience, family history or something they watched on television.
What should health care providers do with the information that appears in this report?
The media is doing something medicine has long struggled with: helping people see death not as a medical failure, but as an inevitable part of life that can be faced with honesty, curiosity, and even hope. Shows and films that portray serious illness, caregiving, or dying authentically are helping people talk about what was once unspeakable. As clinicians, we can build on that momentum.
When a patient mentions a storyline that resonated — a character navigating end-of-life decisions, or a family caring for a loved one — that’s an opening. It’s a natural way to ask, “Has that made you think about what would be important to you if you were in that situation?” These small, genuine moments can spark meaningful reflection and often lead to deeper conversations about values, goals, and care preferences.
Hospice and palliative care teams see, every day, what happens when those conversations haven’t taken place — families arriving at a moment of crisis, uncertain and overwhelmed. Stories in popular culture can help prevent that by giving people language and permission to think and talk about life-limiting illness and the end of life long before it’s urgent.
At the organizational level, health systems can integrate storytelling into patient education — offering simple viewing guides or discussion prompts that help patients and families process what they’ve seen and connect it to their own choices. Sharing what works among colleagues can also help build confidence and normalize these discussions across care settings.
Most of us did not receive in-depth training into have these conversations, but we can learn. By developing communication skills, drawing on palliative care expertise, and recognizing when media exposure has created readiness to engage, we can meet people where they are — in clinic, at home, or even through the stories that move them.
Ultimately, changing how we approach death in healthcare means changing how we talk about it as a culture. Television and storytelling are already opening that door. Our role, as healthcare providers, is to walk through it with our patients — translating awareness into compassion, and conversation into care that truly honors what matters most.