Form a Discussion Group

You Are Invited to Be a Leader

Thirteen/WNET and the Robert Wood Johnson Foundation invite you to become a leader in a nationwide effort to open a dialogue on end-of-life issues. You can do this by organizing and leading discussion groups in your own community. The broadcast production BEFORE I DIE: MEDICAL CARE AND PERSONAL CHOICES, the BEFORE I DIE: A NATIONAL CONVERSATION videoconference, and the outreach materials will give you ideas and help you structure your program.

For your discussion you may want to cover the many issues presented in the program: medical choices, ethical and spiritual decisions, and the costs of dying; or you may want to focus on a particular issue or on local concerns. The important thing is that we need to start talking about these issues. Once we, as a society, feel comfortable addressing and preparing for death, conditions will improve for the dying. We encourage you to participate in a BEFORE I DIE discussion group with members of your community.


1. Starting a BEFORE I DIE discussion group is easy. Contact members of civic organizations; business and professional women's groups; medical and allied professional groups; cancer, AIDS, Alzheimer's service organizations; managed care groups; geriatric service organizations; employee assistance programs; medical societies; consumer leagues; hospital/hospice provider organizations; and bar associations. The outreach associates are also available as a resource. Ask members of these organizations if they would like to meet at a community center, in your home, or at a coffee shop to talk about BEFORE I DIE.

2. View the videoconference, BEFORE I DIE: A NATIONAL CONVERSATION, which will teach you and others how to use the broadcast BEFORE I DIE: MEDICAL CARE AND PERSONAL CHOICES for discussions.

3. Get together with your group to watch the videoconference and broadcast, and open up discussion afterwards.

4. There is no ideal size for a BEFORE I DIE group, but many study group veterans say that six to ten people is an optimum number -- large enough to ensure a lively interchange and diversity of opinion, but small enough so that each person has the chance to participate fully.

5. The starting point of a BEFORE I DIE discussion group must be an openness to different points of view. Keep in mind that hearing new ideas can do more than expand your views; it can also serve to deepen your knowledge of these issues.

6. A group can be made of people from a variety of different backgrounds, occupations, and experiences; the more diverse your group is, the more you will learn about the many sides of each of these issues.

7. Your group can have one leader or rotate leadership. It can meet for one hour or up to three hours.

8. You don't need an expert to lead your group. All you need is a group of people willing to share their beliefs and experiences, and open to hearing the views of others.

9. Your group should plan to meet for the broadcast on April 22, 1997, at 10:00 pm ET. You may want to watch the show together and then discuss it immediately; or might prefer to meet a few days after the broadcast. You may consider starting a regular discussion group every other week or once a month.


1. Usually, one group member acts as the initial group leader. Once the group begins to meet regularly, it works well to rotate leadership.

2. When you act as group leader, it's your responsibility to take care of logistical details and to select key issues for group discussion. Choose a few questions from the Viewer's Guide, Resource Kit, videoconference, or broadcast that you think will spark lively discussion.

3. Have copies of the videoconference, BEFORE I DIE: A NATIONAL CONVERSATION, and the broadcast, BEFORE I DIE: MEDICAL CARE AND PERSONAL CHOICES, the Viewer's Guide, and Resource Kit available for reference. If your group plans to do any of the suggested activities in the Viewer's Guide or Resource Kit, check to make sure that you have any materials that might be needed.

4. Each person who joins the group should read the section on "How to Be a Good BEFORE I DIE Discussion Group Member." From the beginning, it's important for everyone to understand that the key to a successful and rewarding BEFORE I DIE group is to treat others as you yourself want to be treated.


1. Have the group sit in a circle or around a table. You might begin with brief introductions, with each person giving their name, what organization they are with, and a little bit about themselves. Begin with one of the questions from the Viewer's Guide or Resource Kit that you felt would spark lively discussion.

2. As you begin, keep the group focused on the question that you proposed before going off in other directions.

3. Avoid "expertism." No matter how knowledgeable you are, if you present yourself as "the expert," you will change the tone of the meeting and chill discussion. The focus here is meant to be on what the members of your group -- not the experts -- think about BEFORE I DIE.

4. Lead by example. Listen actively when others speak and urge all group members to do the same. When you speak, try to build on comments made by others. You may want to recommend that each speaker begin by acknowledging the comments of the previous speaker. Whether you agree or disagree with the earlier comment is not the only consideration; what matters is that the prior speaker feel that s/he has been heard by the group.

5. Be sure not to monopolize the conversation -- and don't let anyone else dominate, either. Be polite but firm. Don't let people cut others off or "talk over" people who are speaking. Make sure that everyone has a chance to speak. Some of those who've been in discussion groups recommend choosing an object -- a paperweight, a tennis ball -- that can be passed from person to person to indicate who "has the floor." While a person is holding the object, s/he has a right to speak without being interrupted. When s/he is done, s/he recognizes the next person by passing along the object. Others say that they've found it helps to use a chess timer. Each speaker is given a set amount of speaking time for the session.

6. Discussion of and reflection about death and dying can sometimes lead to very personal comments or highly charged responses. While it is important to avoid having a session turn into "group therapy," it is just as important to honor people's feelings and personal testimony. Remind group members to respect confidentiality.

7. If questions arise that cannot be answered or disagreements develop, put them aside for further discussion at your next meeting. Ask someone in the group to assume responsibility for doing some research during the week.


You don't have to be an expert to participate in a BEFORE I DIE group. Remember that the whole point of this program is to encourage everyone to talk about end-of-life issues.

1. Listen -- really listen. If you can really hear what others are saying, the group's discussion will be far more interesting, and you will learn much more.

2. Be honest. People in the group want to hear what you really think, not what you think you should say.

3. Be open to new viewpoints and new ideas. Each of us comes to the group with a different perspective. Try to give all interpretations a hearing.

4. The goals of a BEFORE I DIE discussion group are to learn, share, and understand each other's viewpoints. Even when you disagree, respect others -- their views, their opinions, and, most important, their beliefs. How you say things may be as important as what you say. Try to say "I don't agree with you" instead of "You're wrong."

5. Don't rush to smooth over differences. Try to understand your differences and honor them. There should be no proselytizing -- hidden or overt -- in this setting.

6. Don't monopolize the conversation. Remember that you will learn more from hearing others talk than you will from hearing yourself talk.

7. Come prepared. Watch the programs; read the materials; reflect on your own experience. A good discussion depends on every group member bringing his or her best thinking to the discussion -- as well as his or her feelings and beliefs.

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