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Previous Volume 336:652-657 February 27, 1997 Number 9 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Despite an ethical and legal consensus regarding the right of patients or their surrogates to refuse life-prolonging therapy, surveys show that dying patients in hospitals in the United States frequently receive unwanted interventions.^1,2 One reason for this may be a lack of training among physicians and nurses in the clinical aspects of withdrawing intensive life support. Staff members are highly skilled in aggressive life-extending treatment, and some hospitals now have services specializing in palliative care for patients forgoing life-extending treatment. But there may be no one specifically trained in managing the transition from one style of care to the other. . . . [Full Text of this Article]

Determining Treatment Goals

Specific Agents and Symptoms

Mechanical Ventilation

Dialysis

Artificial Nutrition and Hydration

Counseling and Support

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