Escalation of Commitment in Treatment Decisions Near the End of Life

As a dual board–certified hematologist and palliative care physician, I am convinced that numerous patients with advanced hematologic malignant neoplasms would benefit from early palliative care intervention, given that many of them will not be cured, and suffer from several distressing symptoms. However, for this patient population, early palliative care access is still uncommon, and far less common than for patients with solid tumors. Many patients with advanced hematologic malignant neoplasms receive aggressive treatments or chemotherapy while nearing the end of life and often die in the intensive care unit, even though it is not consistent with their expressed wishes.

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