Decision-Making Approaches Used to Limit Potentially Nonbeneficial Life-Prolonging Interventions

What decision-making approaches do clinicians use to limit potentially nonbeneficial life-prolonging interventions?In this qualitative study of 101 clinician interviews conducted at 3 academic medical centers, respondents reported facing challenges limiting interventions using the approaches recommended in professional society policy statements (ie, shared decision-making, institutional processes addressing disagreement with patients or surrogates). Respondents described alternate approaches (eg, stating a plan to limit interventions, explicitly not offering interventions, not mentioning interventions) in which clinicians limited interventions without a shared decision or institutional process.Clinicians face challenges in limiting potentially nonbeneficial life-prolonging interventions via recommended approaches, which may lead them to resort to alternate approaches.

Corresponding Author: Jason N. Batten, MD, MA, UCLA Department of Anesthesiology and Perioperative Medicine, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Ste 3325, Los Angeles, CA 90095 (jbatten@mednet.ucla.edu).

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