Talking to seriously ill patients about their prognosis, the trajectory of their illness, and their treatment options can be a difficult conversation for clinicians to initiate. Patients are also uncomfortable proactively sharing their feelings on the topic with their physician or their families.  Because of the silence, there is typically a big gap between what a patient wants and what actually happens.

According to a Massachusetts Commission on End of Life Care/Massachusetts AARP survey done in 2005,

According to the American Lung Association, asthma is one of the most common chronic disorders in childhood affecting an estimated 7 million children under the age of 18. Asthma is the third leading cause of hospitalization among children under the age of 15 and is one of the leading causes of school absenteeism. The annual direct health care cost of asthma is approximately $50 billion; indirect costs (e.g. lost productivity) add another $6 billion, for a total of $56 billion dollars.