Difficult End-of-Life Treatment Decisions

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Abstract
Significant concern remains about how well physicians know and follow the treatment preferences of their patients.1 Decisions are particularly problematic for critically ill and dying patients who lose their capacity to make medical decisions. A variety of factors may influence the treatment decisions made for incompetent patients. Physicians may use the probability of survival or recovery in recommending particular treatments. Perceived quality of life can also influence physicians and families. In an attempt to facilitate this process, advance directives were created to allow patients to plan treatment decisions in the event of decisional incapacity.