End of life care preferences.

PURPOSE OF REVIEW

This review considers how end of life care preferences have been dealt with recently in the scientific literature.

RECENT FINDINGS

The ability to make decisions about one's own dying and death is commonly considered a necessary component of a 'good death'. It is important to allow people to express, if they wish, their end of life preferences. Most of the studies were conducted in patients at advanced stages of terminal illness and involved asking them about what their wishes would be in certain scenarios. Half of the papers specifically addressed the issues of life-shortening medical decisions. On considering the findings of the various studies reported in detail here, it becomes clear that end of life preferences would best be studied using a longitudinal design, because of the fluctuation of these preferences over time and their association with dynamic components of quality of life, such as functional status, and psychosocial and spiritual dimensions.

SUMMARY

Both patients and health care workers can be assisted in addressing the issue of what is the right time for a patient to record their preferences, in recognizing psychological defences and their evolution during the end of life process, and in managing conflicts and suffering in the patient-family unit. Guidelines and practical tools have begun to be designed and tested.