| Patients and family/guardians’ perspectives | Healthcare practitioners’ perspectives |
---|---|---|
Alignment to Clinical Benefit or with Agreed Treatment Goals | ||
Non-beneficial treatment | • Attempts at curative or life-prolonging treatments that are not consistent with the agreed goals of care, i.e., especially when these are continued though unlikely to succeed, and/or considered by patient, family/guardians to result in unacceptable quality of life1−19 (n = 19) | • Burden likely to outweigh the clinical benefits of treatment2−4, 9−11, 14−15, 18−42 (n = 32), i.e., would fail to achieve positive results such as recovery, symptom relief, or quality of life improvement • When curative treatment is no longer an option but continues or is escalated leading to excessive or aggressive care (n = 9) 14, 17, 18, 22, 24, 25, 43−45 inhibiting a peaceful death or prolonging the suffering of dying24, 44, 46, 47−49 (n = 6) |
Inappropriate treatment at end-of-life | • Treatment that are counter to the patient’s or family/guardians’ wishes can be deemed inappropriate5, 18, 19 (n = 3) | • It can be deemed inappropriate to extend considerable resources when these are judged likely to exceed the clinical benefits or reasonable hope2, 31, 36, 40, 48 (n = 5) |