Influential guidelines for end-of-life care updated by Hastings Center

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The Hastings Center has updated its “Guidelines for Decisions on Life-Sustaining Treatment and Care Near the End of Life.” The original 1987 guidelines were influential, and were cited by the U.S. Supreme Court in the 1990 case that established the right to refuse life-sustaining treatments.

“The guidelines … encourage health care leaders and administrators to support better outcomes for patients by building more effective forms of care delivery and integrating care near the end of life into organizational safety and improvement initiatives,” said Nancy Berlinger, a Hastings Center scholar who directed the project to update the guidelines.

New additions to the guidelines include a section on palliative sedation and a section on the ethics of cost management and end-of-life care. In particular, healthcare organizations facing fiscal pressures must make decisions about resource allocations. The guidelines urge transparent policies around how these decisions are made.

The Hastings Center is an independent, nonprofit bioethics research institute founded in 1969. The Oxford University Press published the updated guidelines.