Physician's attitude towards end-stage heart failure patient clinical and bioethical considerations

The European Geriatrics Society position statement on the care of dying, patients opens by stating that providing excellent, humane care to patients near the end of life, when curative means are either no longer possible or no longer desired by the patient, is an essential part of medicine". Although the essential nature of this discipline certainly cannot be denied, much of the literature dedicated to this topic has revolved around terminal care provided to patients who have cancer diagnoses. Heart failure presents its own unique challenges to the clinician who desires to make the recommendations of the European Geriatrics Society a tangible reality This article focuses on both specific clinical recommendations and an analysis of some of the ethical issues involved in the provision of care to elderly patients in the terminal stages of heart failure.