Care at the End of Life: Robert Wood Johnson Foundation and Open Society Institute, 1989 and 1994

Center for Strategic Philanthropy and Civil Society (Duke)



Case Study Sector


Motivated by his own experience with the deaths of his parents, philanthropist George Soros in 1994 directed his Open Society Institute to begin the Project on Death in America (PDIA). The project’s goal was to “transform the culture of dying” in the United States.
The Robert Wood Johnson Foundation's interest in care at the end-of-life had begun in 1989, when it funded a five-year study for $28 million. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT) examined the experiences, in U.S. hospitals, of dying people and their families. As a result of the study, the Robert Wood Johnson Foundation sought to promote widespread adoption of palliative and end-of-life care by means of a three-part strategy:

  1. Professional education
  2. Institutional change
  3. Public engagement

Meanwhile, the Open Society Institute pursued a strategy of support for professional development. Over 500 hospitals now have palliative care programs. Virtually every one of these has developed since the two foundations became involved.



  • Field Building
  • Evaluation
  • Partnership
  • Strategy


  • Northern America

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A new report applies a theory of time and value in philanthropy to three real cases, to see how a foundation could decide whether to operate with a limited life, based on the amount and kind of value it hopes to create.


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President and CEO
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