Instability in End-of-Life Goals and Preferences of Patients Who Are Seriously Ill

Are end-of-life care goals and preferences unstable among patients who are seriously ill?This systematic review across 25 studies found 10 studies with at least 50% of patients changing preferences over time. This instability is associated with number of assessments, and influenced by transient factors, such as health status, emotional states and prognostic understanding.These findings suggest that end-of-life care goals and preferences among patients who are seriously ill are unstable; therefore care planning should focus on an ongoing process of preparing patients and families for real-time decision-making rather than relying on predocumented goals and preferences for future medical care decisions.

Corresponding Author: Chetna Malhotra, MBBS, MD, MPH, Associate Professor, Duke-NUS Medical School, Eight College Rd, Singapore 169857 (chetna.malhotra@duke-nus.edu.sg).

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