• Vol. 32 No. 6, 785–789
  • 15 November 2003

End-of-life Care: Challenges and Obligations in Setting Limits to Life-sustaining Therapy



It is now generally accepted that the withholding or withdrawal of interventions that serve only to prolong the dying process is appropriate. Setting limits to life-sustaining therapy are now common practice. However, making such decisions can be challenging. They are also not uncommonly a source of disagreement between the physician and the patient or surrogate. The potential for strained patient-physician relationship can be mitigated by patient-centred, goal-specific care with its emphasis on effective communication, a sense of timing and attention to the various dimensions of the illness experience.

A patient with recurrent stroke disease and severe pneumonia did not respond to the previous courses of antibiotics. The medical team decided to switch to another broad-spectrum antibiotic.

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