My Way Cards were introduced in 2009.

Back then, we only used a real deck of printed cards. People could sort them on a kitchen table or desk. People initially sorted the cards by themselves, so they could take their time to think about their decisions. When they were ready, they discussed their decisions with a counselor who used a clipboard to record their answers. When they were ready, they recorded their interview on video.

In 2017, we introduced the online version. They could view My Way Cards on a laptop, tablet, or cellphone. It was much easier to complete since no clipboard was required. As soon as a person made a treatment choice, the computer stored it. People could return to the program if they wanted to change their decisions. If a person lived far away or could not travel, internet video allowed them to discuss their responses with their counselors. (We were among the first to use telemedicine for advance care planning.)

In 2018, My Way Cards were revised to reflect our clinical experience: The best reason to compel your future physician to honor your requests is that you want to avoid end-of-life severe suffering. This is consistent with the goal of Strategic Advance Care Planning: a peaceful and timely dying.

Some people still prefer to use a real deck of My Way Cards. And we still have them. But they can only be used with a counselor, in-person.

People who want to use a real deck should ask their counselor to call us at 800 64 PEACE (800 647 2332).

As an intensivist, I’ve lived this professionally for over 30 years, trying to help families understand what you have so eloquently written.

Robert L. Levine, M.D., Professor and Founding Chair Department of Emergency Medicine and Critical Care, The Florida International University Herbert Wertheim College of Medicine