On a spring morning in 2026, about two dozen employees and students of a Midwestern community college gathered for an event that most people would rather skip: National Healthcare Decisions Day. The speaker, Odessa Sawyer, a program coordinator with the Center for Practical Bioethics, began by distributing crayons, markers, and coloring sheets. "Having something to do with your hands helps you process and lower those big emotions," she said. The coloring pages featured baby animals eating other baby animals, because, as she put it, "the circle of life is everywhere."

It was an unusual icebreaker for a subject that carries enough stigma to fill a hospital ward. Yet within minutes, the room’s tension visibly softened. Sawyer’s message was clear: advance care planning is not just a medical form you fill out and forget. It is a social, emotional, and legal process that deserves the same deliberate attention you give to buying a car, a house, or raising a child. "If you buy a house, you go through a multitude of hoops," she reminded the audience. "But when something happens to your body, we often have no idea what we want."

Sawyer’s background shapes her perspective. She earned a Master of Social Work after a career as a military police officer in Afghanistan, where she saw death and grief handled in vastly different cultural frameworks. "Interacting with that and seeing grief and death in a different way outside of the American culture was very eye opening," she said. Her current role at the Center for Practical Bioethics — a 44-year-old organization that helps hospitals navigate ethical dilemmas — places her at the intersection of policy, technology, and human dignity. The center’s four ethicists are called in when families clash, when a patient is homeless and no care plan exists, or when artificial intelligence complicates medical decisions.

Sawyer pointed out that AI in hospitals is older than most people realize. MRI machines and many diagnostic tools rely on machine learning. The center now has a team that helps hospitals develop AI policies, which Sawyer called "augmented intelligence" rather than artificial. "It’s taking the human intelligence and switching it into what we need it to be," she said.

But the heart of the talk was not about machines. It was about the three pillars of advance care planning: medical, legal, and social. The medical side involves understanding procedures such as ventilators, feeding tubes, and DNR orders. The legal side involves documents like the advance directive, a patient-led form that covers everything from vaccines to body disposition. Then there is the POLST (Physician Orders for Life-Sustaining Treatment) or, depending on the state, the MOLST form. These are physician-led, pink-slip documents for terminal illnesses, designed to travel with the patient and cover crash-card decisions. "The POLST is mainly to cover physician neglect and EMT neglect," Sawyer said bluntly. "That’s the honest truth."

But the third pillar, the social side, is what Sawyer called the most underserved. "What if you are in a coma? What stories do you want to hear? Where is your rosary, your Quran, your blanket that your mom made you?" she asked. "What are those things that keep you a human being and not just a feeding tube? Who do you want in that room? Who don’t you want in that room?" These questions go beyond standard forms. They require conversations with family, friends, and medical proxies. Sawyer recommended treating the process like any other major life plan: talk to your mom, your best friend, watch videos, consult your insurance agent about color choices. "It is not something you just walk into."

Sawyer acknowledged the emotional weight of the topic. She offered attendees the option to step out, take a breath, or approach her privately later. She also noted the gap for chronic conditions such as dementia and Alzheimer’s, which lack a clear terminal deadline and therefore do not trigger a POLST. "Those frustrate me because there’s not ever a set deadline," she said. "It can go on for years past the point when you can do anything."

For the tech-savvy reader, the takeaway is that advance care planning is a system — a set of interconnected processes that most people never learn to navigate. The medical system checks a box when you say you have a directive, but the social and emotional preparation is yours alone. Sawyer’s approach, built on decades of bioethics work, urges us to treat death as a life stage worthy of the same deliberation as any other milestone.

The Center for Practical Bioethics offers free events and resources, and Sawyer promised to send attendees invitations and free tickets to future talks. But the real work happens at home. As she put it, "Community health is everyone’s job and everyone’s responsibility."

In other words, National Healthcare Decisions Day is not just about filling out a form. It is about deciding how you want to live — and be remembered — right up to the very end.