The American College of Surgeons: statement on principles guiding care at the end of life.

• Respect the dignity of both patient and caregivers. • Be sensitive to and respectful of the patient’s and family’s wishes. • Use the most appropriate measures that are consistent with the choices of the patient or the patient’s legal surrogate. • Ensure alleviation of pain and management of other physical symptoms. • Recognize, assess, and address psychological, social, and spiritual problems. • Ensure appropriate continuity of care by the patient’s primary and/or specialist physician. • Provide access to therapies that may realistically be expected to improve the patient’s quality of life. • Provide access to appropriate palliative care and hospice care. • Respect the patient’s right to refuse treatment. • Recognize the physician’s responsibility to forego treatments that are futile.