What really matters at the end of life

What really matters at the end of life
What really matters at the end of life

BJ Miller’s Talk Summarized:

Life in The Midst of Dying

What do you think about what really matters at the end of life? In his inspiring TED talk, BJ Miller shares his personal journey as a triple amputee, highlighting the importance of aesthetic pleasures, human connection, and life’s simple joys, even as we face the inevitable – death. He underscores the potential of design thinking as a means to revolutionize palliative care and, ultimately, how we approach our mortality.

After a life-altering accident, Miller found himself immersed in a world he didn’t recognize, grappling with the reality of his new life. Despite the immense physical pain and suffering, he learned to draw strength from life’s unassuming beauties – like the mesmerizing transformation of a snowball into water, an experience he vividly recalls. This encounter became a metaphor for his life, teaching him to cherish the fleeting moments that offer profound joy amidst his trials.

Miller extends this message into his professional practice at Zen Hospice Project, advocating for a radical transformation in how we perceive and administer care for the terminally ill.

The Call for a Paradigm Shift in Palliative Care

In his talk, Miller identifies three critical “design cues” in reframing our approach to end-of-life care:

  • Alleviating unnecessary suffering.
  • Maintaining dignity and indulging in sensory pleasures.
  • Prioritizing wellbeing and redefining patient care as a creative act.

He emphasizes the importance of reducing what he terms “foolish suffering,” – the avoidable pains that healthcare systems, as we know them, often inflict on patients due to outdated policies and lack of foresight.

Miller advocates for a new infrastructure that acknowledges the aesthetic and sensory needs of patients. He shared poignant stories of patients’ simple wishes – like smoking French cigarettes, or having a beloved pet nearby. These seemingly minor comforts can greatly enhance a patient’s sense of being alive, thus improving their quality of life.

Finally, Miller asserts that healthcare should strive to enhance life’s richness, rather than merely reducing its hardships. This compelling perspective challenges us to see palliative care as a means to enrich lives, even as they near their end.

Insights and Takeaways

The Power of Design Thinking in Healthcare

Miller’s talk suggests that the principles of design thinking can be fruitfully applied in healthcare. This innovative approach, which places the users’ needs at the forefront of problem-solving, could revolutionize palliative care.

Design thinking could help us build a patient-centric model of care that factors in patients’ unique needs and preferences, focusing not just on medical outcomes, but also on overall quality of life. The Bureau of Labor Statistics reports that as of 2021, there are 3.1 million registered nurses in the United States. With such a large workforce, adopting a design thinking approach in nursing could profoundly impact how we care for the terminally ill.

Valuing Quality of Life in the Face of Death

Another insight from Miller’s talk is the significance of maintaining the quality of life, even when death is imminent. According to the World Health Organization, palliative care aims to improve the quality of life for patients and their families facing problems associated with life-threatening illness. Miller’s talk emphasizes the importance of sensory experience and aesthetics, reminding us that patients’ needs extend beyond the purely medical.

Why We Should Recommend This Video

This TED talk has valuable lessons for everyone, regardless of their profession or life stage. It challenges us to see beyond our fear of death and focus instead on making the most of our lives.

In conclusion, Miller’s talk serves as a powerful reminder to healthcare providers, policymakers, and individuals to rethink how we view palliative care, aging, and death. His vision for a more compassionate, human-centered approach to end-of-life care is something we can all learn from.

  • “Let death be what takes us, not lack of imagination.” – BJ Miller


  1. TED: “What really matters at the end of life | BJ Miller
  2. Bureau of Labor Statistics: “Registered Nurses
  3. World Health Organization: “WHO Definition of Palliative Care
What really matters at the end of life | BJ Miller

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