Differences in end-of-life care decision making between patients with and without cancer

Am J Hosp Palliat Care. 2015 Dec;32(8):797-801. doi: 10.1177/1049909114542646. Epub 2014 Jul 8.


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.

Keywords: advance care planning; advance directives; cancer; end-of-life care; hospice; palliative care.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Advance Care Planning*
  • Aged
  • Aged, 80 and over
  • Child
  • Decision Making*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / therapy*
  • Retrospective Studies
  • Terminal Care / methods*
  • Young Adult