A collaborative study including Dr. Kathleen Benton, alumni of the Jiann-Ping Hsu College of Public Health at Georgia Southern University examines the influence of race on end-of-life choices following counselor-based palliative consultation. Black Americans are more likely than Whites to choose aggressive medical care at the end of life. We present a retrospective cohort study of 2843 patients who received a counselor-based palliative care consultation at a large U.S. southeastern hospital. Before the palliative consultation, 72.8 percent of the patients had no restrictions in care, and only 4.6 percent had chosen care and comfort only (CCO). After the consult, these choices dramatically changed, with only 17.5 percent remaining full code and 43.3 percent choosing CCO. Both before and after palliative consultation, Blacks chose more aggressive medical care than Whites, but racial differences diminished after the counselor-based consultation. Both African American and White patients and families receiving a counselor-based palliative consultation in the hospital make profound changes in their preferences for life-sustaining treatments.