Medical advances are constantly expanding diagnostic and therapeutic options, but at the same time make it more difficult to determine appropriate treatment goals. Therapeutic decisions are often guided more by feasibility than by individual appropriateness, which can lead to overtreatment. This refers to the use of medical interventions when treatment goals are no longer achievable, with the potential harm outweighing the benefits. In addition to direct negative effects on patients, overtreatment also has significant indirect consequences, including rising healthcare costs, growing resource constraints shortages and moral stress within treatment teams.
The causes are complex and lie at the level of those affected, the healthcare providers and the care structures. The early integration of palliative care can have a preventive effect by supporting the clarification of realistic treatment goals, the consideration of the patient’s wishes and appropriate decision-making. To reduce overtreatment, structural and health policy measures are particularly necessary, including the expansion of palliative care services, the promotion of advance care planning, and the improvement of training and continuing professional development in communication and decision-making.
At the time of publication, all authors were members of the German Society for Palliative Medicine (DGP).
