About the Stanford Letter Project

Our goal: To help, empower and support all adults to prepare for their future and take the initiative to talk to their doctors and their friends and family about what matters most to them at life's end.

All of us will face the end of life one day. Contemplating one’s own death and doing some basic preparatory work is certainly not an easy task. However, the emotional, physical and the financial toll of not doing so is exorbitantly high. People who do not clearly document their wishes and preferences for care at the end of life are often subjected to futile medical treatments that they neither seek nor benefit from. Their families are burdened by the medical bills accrued from the numerous ineffective treatments many patients get at the end of life. In fact, a large research study showed that 62 % personal bankruptcies are due to medical expenses. Over 75% of the people who became bankrupt due to medical expenses had some form of health insurance (i.e., having health insurance does not protect you and your family from medical expense related financial crises).

A major reason for all these problems is that most Americans don’t like to talk about and prepare for the last phase of life. Our research has shown that people find it extremely difficult to discuss this important issue both with their doctors and with their friends and family.

We started the Stanford Letter Project in 2015 based on many years of research and discussions with people from various cultural and social backgrounds. We conducted interviews and focus groups in multiple languages with people in the community and talked to numerous patients and their family members as well as health professionals. We found that while almost all doctors agree that it is important for them to have end-of-life conversations with their patients, most doctors struggle with these conversations. We also found that patients from all ethnic backgrounds feel that is very important for them to have end of life conversations with their doctors and their family members. However, patients do not quite know how to initiate these conversations.  

Based on these research findings, we created the Letter Project tools to help you write letters about your wishes for care in the future.

These letter templates are specifically designed to help you voice the key information needed to help you prepare for the future.  Use the Stanford Letter Project tools today to write to your doctor, your friends, and your family. It is free, easy, and extremely important.

Questions? : Email us at periyakoil@stanford.edu.

Letter Project Tools:

  • What Matters Most Letter: This is a letter template that allows anyone to document what matters most to them and what treatments they want in the future. This tool is free and is available in print, as an online fillable form and as an iPhone and Android App in eight different languages.
  • Friends and Family Letter: This letter can help all adults complete their seven life review tasks: acknowledging important people in our lives; remembering  treasured  moments in our lives; apologizing to those we may have hurt; forgiving those who have hurt us; and saying “thank you,” “I love you” and “goodbye”. Using this template, you can write a letter to your friends and family in one of eight languages using an online form, an iPhone or Android App or a printable form.
  • Many health care systems in the US are using the Letter Advance Directive. Numerous people throughout the world have utilized these templates to document their wishes for care at the end of life. The Letter project has been featured extensively in the popular press and is growing and expanding rapidly.