Treatment intent refers to the aims of treatment as agreed upon by the doctor and patient in cooperation. With the patient’s permission, the discussion may even include the patient’s loved ones.
The appropriate treatment intent provides the patient with the best possible medically justified treatment in accordance with the patient’s values and wishes. Decision on the treatment intent is usually made in a care meeting, often involving the patient’s family or other loved ones with the patient’s permission. If the patient is unable to express their wishes, their loved ones can provide this valuable information.
Pain and other symptoms are always treated, regardless of treatment intent.
Curative treatment intent aims to permanently cure the illness. Measures taken to achieve this goal include surgical treatment of localised breast cancer or hip fracture. The duration of treatment is typically limited.
Even if the illness can’t be cured, there are often treatments that can be used to slow down its progression or prevent exacerbation. In such cases, the treatment aims to control and delay the progression of illness, and the goal is to maintain a high quality of life for a longer time. Treatments used to achieve this include chemotherapy used to treat many types of advanced cancer, treatment for congestive heart failure, or dialysis for kidney failure.
Palliative care is incorporated into all treatment intents to relieve symptoms. Transition to palliative treatment intent, on the other hand, takes place once the progression of the illness or the patient’s life expectancy can no longer be improved with treatment to any significant extent. At this stage, the aim of care is to relieve symptoms, maintain the patient’s quality of life, and ensure that the remainder of the patient’s life with the illness is as good as possible.
When the illness (for example cancer) is unresponsive to treatment, or the treatment causes more harm than good, treatment targeting the illness leads to decreased quality of life and may even shorten the patient’s life expectancy. This is why a timely transition to palliative treatment intent is important. This does not mean giving up, but rather providing the best possible treatment with the appropriate intent.
Once the transition to palliative treatment intent has been made, the patient may still live for several months – sometimes even a few years.
To ensure that everyone concerned is aware of the palliative treatment intent, the doctor may use the diagnosis code Z51.5 as clarification.
Hospice care refers to palliative care at the very end of life, making it a part of palliative treatment intent.
The decision to move to hospice care is made when death is likely to occur in the coming days or weeks. This makes it easier to focus on aspects of care relevant to the dying person, such as immediate symptom relief, saying goodbye, and psychological or existential support.
Hospice care is also a significant stage in terms of those close to the patient preparing for what’s to come. During hospice care, the support offered to the patient’s loved ones becomes especially relevant, and continues after the patient’s passing.
Updated 27.3.2025
