Acute hospitalization of near-death patients can result in unnecessary suffering

Clinical Question

Does the hospitalization of patients with acute problems at the end of life add to their suffering?

Bottom line

Suffering, which is different from pain, occurs when a person experiences a threat to their wholeness as a person. It may occur because of myriad experiences, including medical treatments. The experience of acute hospitalization of patients near death can worsen their suffering. Avoiding futile measures, treating them with respect and dignity, and attending to the unpleasant milieu of the hospital environment may decrease this unnecessary suffering.(LOE = 4)

Overuse alert: This POEM aligns with Choosing Wisely Canada's serious illness conversation initiative.

Study design: Qualitative

Funding: Self-funded or unfunded

Setting: Inpatient (ward only)


Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA

Discuss this POEM


Arup Kumar Dhara

Impact assessment


James Duncan Stephenson


Yes yes yes. We are assaulting near death patients with unnecessary acute care algorithms.
I’m 40 years an FP. People die and we need to be able to recognize this and get out of the way when appropriate


" Acute hospitalization of near-death patients can result in

Post ER admission of frail elderly patients we-Canadians- 1. should aim to get the patient into a hospital bed as quickly as possible and not the long delays seen all across Canada, 2. stop holding patients in a ER bed positioned under bright lites and under loud speakers with continuous hospital announcements-all inhuman practices that enhance suffering-no wonder death occurs soon after.


end of life patients

don't send to hospital