Which statement best describes when to shift from curative to comfort care?

• A. When there is potential for cure and ongoing improvement
• B. When prognosis worsens, QoL declines, and treatments provide no meaningful benefit
• C. When the patient requests more antibiotics
• D. When prognosis worsens, QoL declines, and treatments provide no meaningful benefit

Answer: (D)

Shifting from curative to comfort care hinges on whether ongoing treatments actually help in a meaningful way given the person’s prognosis and personal goals. When prognosis worsens, quality of life declines, and treatments no longer provide a meaningful benefit, the focus should move from curing disease to relieving suffering and aligning care with what matters most to the patient. This moment is where goals of care discussions become central, guiding decisions toward comfort, symptom control, and support, rather than pursuing aggressive interventions that may extend life but also prolong distress.

If there is still a reasonable chance that treatment will improve outcomes or restore function, continuing curative efforts is appropriate. Likewise, requests for additional treatments are considered within the broader context of goals and potential benefit; they aren’t by themselves a cue to switch to comfort care unless they no longer offer meaningful improvement or worsen quality of life.