Treatment Decisions after Brain Injury — Tensions among Quality, Preference, and Cost

Many patients with sudden severe brain injury from stroke, trauma, or cardiac arrest die after family members and clinicians decide, given a poor prognosis, to withdraw treatment. Although it's difficult to estimate precisely how prevalent this trajectory to death is, as many as 60% of deaths from stroke, heart disease, and traumatic brain injury may involve some kind of treatment withdrawal, which makes it one of the most common pathways to death in the United States. Treatment withdrawal in acute brain injury differs from other terminal trajectories in many respects, including the fact that aggressive treatment might allow at least . . .