Goals of Care Toward the End of Life: A Structured Literature Review

Goals of care are often mentioned as an important component of end-of-life discussions, but there arc diverse assessments regarding the type and number of goals that should be considered. To address this lack of consensus, we searched MEDLINE (1967-2007) for relevant articles and identified the number, phrasing, and type of goals they addressed. An iterative process of categorization resulted in a list of 6, practical, comprehensive goals: (1) be cured, (2) live longer, (3) improve or maintain function/quality of life/independence, (4) be comfortable, (5) achieve life goals, and (6) provide support for family/caregiver. These goals can he used to articulate goal-oriented frameworks to guide decision making toward the end of life and thereby harmonize patients' treatment choices with their values and medical conditions.