Demands and requests for 'inappropriate' or 'inadvisable' treatments at the end of life: what do you do at 2 o'clock in the morning when …?

In an era when healthcare has become increasingly complex and patient expectations are higher than ever before, we can find the decision-making process for patients, potentially at the end of their lives, increasingly difficult. In the shift from paternalism to patient choice, we can struggle to know what to do when faced with a patient, their family, or both requesting or demanding inadvisable, inappropriate, or futile treatments. It can feel as if we are being asked to subject patients to intrusions and interventions that 'just feel wrong'. In this article, we aim to look at how ethical frameworks, legal statute, case law, and professional guidance, as they apply in the UK, interact when we make these decisions, and we discuss some of the conflicts and challenges that such guidance pose.