Despite the increased use of the term ‘‘end of life’’ and ‘‘end-of-life care’’ in health-care and nursing literature,
over the last 30 years, there is no exact definition of what constitutes the time interval referred to as
end of life.10 The period of time and types of patients who are considered to receive specific ‘‘end-of-life
care’’ such as hospice service may be defined by regulatory, policy, or administrative guidelines, but there is
no scientific evidence to support the clinical indications characterizing a period of end of life.10 This lack of
clinical evidence is largely due to the difficulty of reliable prognostication.11,12 To date, there is no clear
clinical indicator to predict time of death. Therefore, it is impossible, and may be unreasonable, to mark
a date such as 6 months before the predicted death as the beginning day of an end-of-life period
Despite the increased use of the term ‘‘end of life’’ and ‘‘end-of-life care’’ in health-care and nursing literature,over the last 30 years, there is no exact definition of what constitutes the time interval referred to asend of life.10 The period of time and types of patients who are considered to receive specific ‘‘end-of-lifecare’’ such as hospice service may be defined by regulatory, policy, or administrative guidelines, but there isno scientific evidence to support the clinical indications characterizing a period of end of life.10 This lack ofclinical evidence is largely due to the difficulty of reliable prognostication.11,12 To date, there is no clearclinical indicator to predict time of death. Therefore, it is impossible, and may be unreasonable, to marka date such as 6 months before the predicted death as the beginning day of an end-of-life period
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