Not surprisingly,
disagreements over ‘‘do not resuscitate’’ orders may
be the result of confusion regarding the goals of
care.39 To be more goal oriented, end-of-life decision
making requires communication that allows interventions
to be situated within a framework of agreed
upon goals. Without such a framework of meaning,
choices about specific interventions risk disorientation
due to detachment from the patient’s underlying
values.
As important as goals of care are, they are not
without challenges. When goals of care are more
general than specific, interpretation will be necessary.
20,26 When goals of care are multiple—which