End-of-life decision making--have we got it right?

There are wide-spread misconceptions about palliative care. Various treatments used in palliative care have a potential to shorten, and at times even prolong life. However, such treatments are used with a view to enhance quality of life and/or death. Withholding and withdrawal of life-prolonging treatments are not equivalent to assisting death. It is important that patients who are approaching death are sensitively encouraged to make informed choices about such treatments. At the same time, there is no obligation on part of a health professional to provide a futile treatment. This personal view of two palliative care physicians aims to explore some of the difficulties surrounding end-of-life care.