http://jco.ascopubs.org/content/early/2015/12/31/JCO.2015.64.3379.full

This essay was published in the Journal of Clinical Oncology, and reflects a common scenario. An elderly lady, ex smoker, gets admitted to the hospital for breathing difficulty. She is otherwise self sufficient, living independently. Scans show a mass suspicious for cancer, and she would like no additional intervention. She would like to go home and die. She gets talked into investigation to establish that she has cancer, so that she can be offered treatment. She reluctantly agrees. This leads to procedures, complications and an uncomfortable death during this process.

Before we march down this path, we need to listen to our patients. We need to carefully evaluate whether any additional intervention is going to add time or quality to their lives. Not every nail needs a hammer.