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Physicians’ beliefs may override cancer patients’ wishes for end-of-life care, study finds

Spending on cancer care in the last month of life varies widely across the U.S. A new study points to physician attitudes as a major reason.
Source: John Moore/Getty Images

Dr. Nancy Keating has seen what too much health care looks like. The Harvard Medical School professor recalls a patient with metastatic lung cancer who, despite not wanting chemotherapy, was convinced by her doctor to try a more targeted treatment. The patient spent the end of her life in the hospital – the exact place she had hoped to avoid.

Keating, also a physician at Brigham and Women’s Hospital, studies how to deliver high-quality care to patients with cancer. Her latest work examines the factors that contribute to large hospital-by-hospital differences in end-of-life spending for cancer patients. The new study reveals that the variation in the intensity of treatment stems more from the availability of services and physicians’ discomfort navigating end-of-life choices than from patients’ wishes.

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