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futility, multidisciplinary team, palliative care, quality of life



  1. Kirsch, Nancy R. PhD, PT, DPT


Decisions that occur at the end of life are complicated, involving the patient, family, and the healthcare providers. The multiple needs of the patient at the end of life often require the involvement of multiple disciplines. These healthcare providers are part of a multidisciplinary team whose roles on the team have been evolving. End-of-life issues are further complicated by improved technology that permits life to be extended and delays natural death. In making the many ethical decisions at the end of life, multidisciplinary team members lend their expertise. There are times when the desires of the family and/or significant others are in conflict with the recommendations of the team, and this often raises other ethical concerns and conflicts. The right of the patient to express his or her wishes regarding care at the end of life and to have those desires implemented by the team raises additional ethical questions. Finally, the decision to treat or to discontinue care because it is futile raises another set of ethical questions that deal with justice and nonmaleficence. Decisions at the end of life involve an in-depth look at the patients, their quality of life, and the preferences that have been previously communicated if they are unable to communicate them at the time the decision needs to be made.