When we think about healthcare, most of us imagine doctors diagnosing a problem and offering a treatment to fix it. But in reality, modern medicine often works within a specific framework called the medical model. In this system, healthcare focuses on identifying diseases, applying treatments, and monitoring outcomes, but rarely, particularly when nearing the end of life, on curing the problem completely. Instead, it becomes a continuous cycle: diagnosis → treatment → evaluation → new diagnosis. This loop can continue indefinitely, especially for people with advanced or chronic illnesses.

One of the challenges of the medical model is the pressure it places on doctors. Many physicians are trained to see success as offering the next treatment option. When no further treatments remain, some may feel like they’ve failed — not because of the patient’s experience or wishes, but because the system they work within equates “doing something” with success. This can lead to situations where treatments continue even when they might no longer improve quality of life.

In contrast, the nursing model of care, used by advanced practice registered nurses, takes a more holistic and preventative approach. It considers the whole person — their physical, emotional, spiritual, and social needs — rather than just the disease they’re experiencing. This model asks what matters most to the person, not just what can be done medically. A combination of these models can mean getting the care you want at the end of life.

That’s why it’s so important for you and your healthcare proxies to actively advocate for your best interests. Medical teams might suggest tests or treatments because it’s the next step in the cycle, not necessarily because it aligns with your goals. It’s up to you — or the person you’ve trusted to speak for you — to evaluate these options and decide whether they make sense for your situation.

In these conversations, you’re also teaching your doctors, nurses, and care team where you are emotionally, physically, and spiritually. Be insistent about what matters most. Remember: this is about your wishes, not what family members, friends, or even doctors might want for you.

The best way to stay in control is to document your wishes, discuss your goals, and determine what care is right for you. By doing this, you can get the treatment you want, or you can break free from the treatment cycle if that is your choice. Either way, you can focus on what matters most to you.

Compassion & Choices is dedicated to providing resources like the End-of-Life Decisions Guide & Toolkit to help you prepare for the care you want at the end of life. Find this and other resources here.

Donor and Supporter Privacy Policy — Contact
Texting Privacy Policy
Media Contacts
It's Not Assisted Suicide