Transitioning to Comfort-Focused Care at the End of Life

Abstract

Shared decision making requires the exchange of information from the patient and the surgeon (and ideally involves the expertise of the entire multidisciplinary team) to determine the medical and/or surgical treatment that best aligns with the patient's goals and values. Should the surgical patient wish to transition to end-of-life care, the transition to comfort-focused care is within the scope of practice for surgeons. Incorporating the expertise of other health care professionals is an important consideration for whole-patient care. Integrating primary palliative care into surgical practice can help mitigate unnecessary suffering and allow a smoother transition to comfort-focused care.

Keywords: Advance care planning; Advanced directives; Comfort measures; End-of-life decision making; Goals of care; Surgical buy-in; Surrogate decision makers; Symptom management.