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pmid33231982      StatPearls-/-ä 2025 ; ä (ä): ä
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  • Termination of Life Support #MMPMID33231982
  • Dabi A; Rahman O
  • StatPearls-/-ä 2025[Jan]; ä (ä): ä PMID33231982show ga
  • According to the World Health Organization, palliative care is described as "an approach that improves the quality of life for patients and their families facing problems associated with life-threatening illness. This is achieved through the prevention and relief of suffering by means of early identification, thorough assessment, and effective treatment of pain and other physical, psychosocial, and spiritual issues." Physicians in both inpatient and outpatient settings increasingly encounter terminally ill patients, whether managing acute care situations or chronic conditions. In inpatient settings, critical care physicians and hospitalists frequently treat patients nearing the end of life due to acute catastrophic events, rapid decline, or complications from chronic comorbidities. Factors such as advanced age, multiple chronic conditions (eg, cancer, stroke, and heart and renal failure), the increasing number of invasive procedures, and the impact of the COVID-19 pandemic have contributed to situations where death is imminent. The United Kingdom General Medical Council defines individuals "approaching the end of life" as those likely to die within the next 12 months, including patients who may pass away within hours or days. Most people, including healthy individuals in Western societies, prefer to die at home if given the choice. Given the factors mentioned, physicians must be well-versed in the principles of end-of-life care. While clinicians aim to provide curative treatments, offering patients the option of a dignified "good death" remains crucial when a life-threatening disease cannot be cured. Most patients describe a "good death" as being pain-free, distress-free, with effective symptom control, and occurring in their preferred location surrounded by loved ones. They often wish to minimize the burden on their families, settle personal affairs, and maintain mental clarity while retaining a sense of value for the life they have lived and achieving closure. These desires can be summarized by the term "comfort measures." Implementing comfort measures for patients with terminal illnesses requires understanding disease mechanisms, therapeutic options for symptom relief, social considerations, and the processes involved in arranging appropriate care settings.
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