Original ArticlesFacing Death A Critical Analysis of Advance Care Planning in the United StatesSullivan, Suzanne S. MBA, BSN, RN, CHPN; Dickerson, Suzanne S. DNS, RN Author Information University at Buffalo, The State University of New York (Ms Sullivan and Dr Dickerson). Correspondence: Suzanne S. Sullivan, MBA, BSN, RN, CHPN, University at Buffalo, The State University of New York, 3435 Main St, 101 Wende Hall, Buffalo, NY 14214 ([email protected]). The authors have no conflicts of interest to report. Advances in Nursing Science 39(4):p 320-332, October/December 2016. | DOI: 10.1097/ANS.0000000000000138 Buy Metrics Abstract Studies have shown that advanced care planning improves communication and reduces suffering for patients and their bereaved caregivers. Despite this knowledge, the rates of advance care plans are low and physicians, as the primary gatekeepers, have made little progress in improving their rates. Through the lens of critical social theory, we examine these forces and identify the ideologies, assumptions, and social structures that curtail completion of advanced care plans such as Preserving Life, Ageism, Paternalism, and Market-Driven Healthcare System. A critical discourse provides suggestions to eliminate oppressive ideologies that act as barriers to advanced care planning. © 2016 Wolters Kluwer Health, Inc. All rights reserved.