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Prim Care. 2009 Dec;36(4):811-23; table of contents. doi: 10.1016/j.pop.2009.07.006.

End of life decision-making for cancer patients.

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Division of Geriatric Medicine, Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA.


This article reviews research on end-of-life (EOL) decision-making in general and published guidelines on communicating with patients about EOL treatment options. The literature on EOL decision-making, most of which concerns advance care planning decisions, has identified several factors that influence treatment choices including race, religiosity, current health, and family conflict. This literature also documents widespread lack of understanding about dying and palliative care and fears of abandonment by health care providers. This article reviews guidelines for communicating with patients, stresses the role of prognostication in good decision-making, and provides numerous suggestions for initiating and structuring conversations with patients and families about EOL care.

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