ABSTRACT
Treatment decisions at the end of life are common in contemporary clinical practice. According to Broeckaert and the Flemish Palliative Care Federation ( 2009 ), treatment decisions at the end of life, in principle, can be grouped into three categories. The fi rst group encompasses decisions whether to initiate or withhold, continue or withdraw curative or life-sustaining treatments (e.g. cardiopulmonary resuscitation, artifi cial ventilation, dialysis, artifi cial nutrition and hydration). In this group, non-treatment decisions refer to ‘withdrawing or withholding a curative or life-sustaining treatment, because in the given situation this treatment is deemed to be no longer meaningful or effective’ (Broeckaert and the Flemish Palliative Care Federation 2009 : 30-2). According to the British Medical Association ( 2007 ), treatment is usually unable to produce the desired benefi t either because it cannot achieve its physiological aim or because the burdens of the treatment are considered to outweigh the benefi ts for the particular individual. This is called ‘futile’ treatment. Refusal of treatment occurs when the patient requests curative or life-sustaining treatment to be withdrawn or withheld.
