每年有近25万美国人死于或死于慢性阻塞性肺病(COPD)。许多病人在长期的功能衰退后死亡，并伴有许多痛苦。虽然在心理和心理上很难预测，但对死亡的预期为规划和准备临终关怀打开了大门。流行病学家已经开始识别特征的慢性阻塞性肺病患者最有可能在6 - 12个月内死亡,包括严重的、不可逆转的气流阻塞,严重受损和运动能力下降和性能状况,年龄,伴随心血管或其他附带产生疾病,最近住院急性护理的历史。当许多这些特征适用时，鼓励临床医生提出死亡计划这一困难的主题。患有严重疾病的患者通常会接受双重治疗方案的建议:“抱最好的希望，期待最好的结果，做最坏的打算。”医advance planning is best pursued in an out-patient office during a prescheduled, 3-way conversation between patient, health care proxy, and physician. An advance directive can be written after the meeting to summarize the conversation. Clinicians should consider recommending hospice care when a COPD patient is at high risk of respiratory failure from the next chest infection and in need of frequent or specialized home care. Preparation for death should include a realistic appraisal of the prospects for dying peacefully at home and a contingency plan for terminal hospitalization, should the need arise.