Conflicts regarding decisions to limit treatment: a differential diagnosis

JAMA. 2000 Feb 16;283(7):909-14. doi: 10.1001/jama.283.7.909.


Conflicts between physicians and families about end-of-life decisions create challenging and emotionally difficult situations. In this article, we propose a "differential diagnosis" of such conflicts, distinguishing and describing the characteristics of families, physicians, and organizations and society that contribute to the "etiology" of the situation, as well as strategies for "diagnosing" the dominant factors. As a medical model, the differential diagnosis can be a useful tool to help physicians understand and manage conflicts about end-of-life care.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Comprehension
  • Decision Support Techniques*
  • Dissent and Disputes*
  • Ethics, Medical*
  • Family
  • Group Processes*
  • Humans
  • Life Support Care*
  • Medical Futility
  • Physicians
  • Resuscitation Orders
  • Social Values*
  • Terminal Care*
  • Trust
  • Uncertainty
  • Withholding Treatment*