Differences in End-of-life Care Decision Making Between Patients With and Without Cancer

Abstract

Background: Most patients and families do not want invasive life-sustaining procedures when recovery is unlikely. We compared the clinical features of advance directives (ADs) of patients with and without cancer. Methods: The ADs were obtained from retrospectively reviewing electronic medical records of 699 consecutive patients who died from April 2011 to July 2012. Results: Patients with cancer were more likely to have written ADs: 265 (85.8%) patients with cancer and 277 (71.0%) noncancer patients ( P < .001). Significantly more noncancer patients were in the intensive care unit, indicating that they had received or were receiving invasive treatments. Noncancer patients requested life-sustaining treatment more frequently but symptom control less frequently than patients with cancer. Conclusion: Advance care planning in patients with incurable, noncancer disease is important to guarantee patient autonomy at the end of life.