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Medline ® Abstract for Reference 69

of 'Palliative care: Medically futile and potentially inappropriate therapies of questionable benefit'

Easing the burden of surrogate decision making: the role of a do-not-escalate-treatment order.
Jacobsen J, Billings A
J Palliat Med. 2015 Mar;18(3):306-9. Epub 2015 Feb 11.
We present a case illustrating the common problem of a surrogate decision maker who is psychologically distressed over the medical team's recommendation to withdraw life-sustaining treatment. We suggest how a do-not-escalate-treatment (DNET) order can be helpful in such situations when the usual approaches to withholding or withdrawing care are not acceptable to the surrogate. We define a DNET order, explain when it might be useful, and discuss how it can facilitate a humane, negotiated resolution of differences.
1 Palliative Care Division, Massachusetts General Hospital , Boston, Massachusetts.