“We need to change the way the people we love are dying,” Pulitzer-Prize winning columnist and Conversation Project founder Ellen Goodman told an attentive audience in Bethlehem during her presentation on “The Most Important Conversation America Isn’t Having,” sponsored by the Dr. and Mrs. Max Littner Memorial Lecture Series and St. Luke’s University Health Network.

Speaking at Central Moravian Church in Bethlehem, Goodman said the conversation she is talking about is how our loved ones want to live the last years of their lives, what kind of medical care they want, and who should make the decisions for them if they can’t.

While a Conversation Project survey revealed that 90 percent of Americans think it is important to have the conversation, Goodman said that only 30 percent are actually talking about the issues.

Goodman also quoted some sobering statistics about end-of-life decisions:

• One out of 10 have surgery in the last week of life.

• Seventy percent of people say they want to die at home surrounded by people they love, but 70 percent die in hospitals and nursing homes.

• One out of five patients is treated by decisions made by physicians.

• Americans assume those conversations take place with doctors, but only 7 percent actually have that conversation.

“How to start the conversation is the hardest part,” Goodman acknowledged. “Talking about death feels suspiciously and superstitiously like telling death to come into the room,” she said, adding later that conversations have to be non-medical and non-scary.

“We start by making it a normal transition in various stages of life. We want to get people talking about these issues around the kitchen table – not in the intensive care unit.”

Goodman said it was after her mother’s death that she started the Conversation Project to help people talk about their wishes for-end-of-life care. “In her 80s, my mother could no longer decide what she wanted for lunch, let alone make medical decisions.” Because they had not had the conversation, Goodman said she had to make all the decisions without really knowing what her mother wanted.

After her mother died, Goodman began to talk to others about her experience and to share stories. That was the beginning. “Everyone has a story, but only when those stories are shared do we begin to have social change.”

Goodman said medicine is becoming more people-centered, with Medicare now paying doctors and counselors for time spent with patients discussing end-of-life decisions, but she said she sees the real change coming from outside the health care system. “Baby boomers are a pro-change generation. We are a generation poised to decide how we want to die.”

She urged everyone in the audience to help promote the conversation and social change. “We are truly at a tipping point.”