<p>This compare/contrast case study explored the role of religiosity on completion of advance directives in preoperative open-heart surgery patients. Eight preoperative aortic valve replacement cardiac surgery patients were interviewed at Cleveland Clinic, five of whom had completed an advance directive and three of whom had not. In vivo, descriptive, affective, and axial coding was used to analyze results. “Caring for family” emerged as the primary reason for completing, or planning to complete, an advance directive. The values underlying spiritual and religious beliefs appeared to be more important than the beliefs themselves in completing advance directives.</p>