Breaking with the status quo in end-of-life care through de-implementation

Breaking with the status quo in end-of-life care through de-implementation 
Journal of Internal Medicine; by Chetna Malhotra, Ellie Bostwick Andres; 4/17/25
This paper addresses the challenge of de-implementing low-value care practices in the end-of-life (EOL) context, where burdensome interventions often offer marginal life-extending benefits, incur substantial costs and diminish quality of life. We examine the complexities involved in discontinuing such practices, including clinician biases, institutional cultures favouring aggressive interventions and communication barriers among healthcare providers, patients and families. ... De-implementation at the EOL requires sensitivity to the complex, emotional nature of EOL care and provides a unique opportunity to integrate palliative care approaches and improve overall EOL care quality.