Advance care planning (ACP) has undergone criticism for a paucity of evidence that it improves the quality of care, decision-making, or the experience of the patient, their family, and the clinician at the end of life.1 After so much effort for admittedly limited results, why do clinicians, patients, their families, investigators, health care administrators, and policymakers keep trying to make ACP bear fruit? Originally, ACP arose from an ethical obligation to ensure patients have a voice in their care. As we become increasingly aware of systemic racism and inequities in health care, that obligation seems more pressing than ever. We should keep aiming for ACP, but how?