To the Editor.
—The SUPPORT project1 seems to place the blame for the demonstrated breakdown in communication between physicians and patients squarely on the caregiver. Is this fair? I have spent much of the last 20 years working to empower people to take control of how they are cared for at the end of life. In so doing, I have met many caring nurses and physicians and seen the situations with which they are faced. If I were a physician in a hospital setting, I would hesitate to initiate the subject of end-of-life care if I had never communicated on such a difficult issue with the patient at an earlier time in a less-threatening setting. We must devise the means to make end-of-life care easier to broach. I suggest that when a patient arrives for an appointment with his or her physician, the patient can be asked to fill