title: Preventing aggressive interventions in terminally ill patients.
abstract: Invasive procedures in terminally ill patients often fail to change the course of the illness and may result in actual harm. The first step for good end-of-life decision making is to identify, explain and negotiate goals with the patient and his or her family, and to collect and share information. Before doctors try to explain medically reasonable choices, they must listen to what the patient or family already understands about the atient's condition. Useful questions include 'why have you decided to? 'What are you hoping we can achieve?' Phrases like 'stopping treatment' should be avoided as this may add to a sense of conflict.