TABLE 1.

Categories of Circumstances Before End of Life

Categories	Definitions
Full resuscitation (rearrest/intractable shock)	Cardiopulmonary arrest despite maximal medical therapy. No care is actively withdrawn before death pronouncement.
Limitations or withholding of life support or resuscitation	Patient has preexisting or new wishes limiting implementation of NEW supportive care (i.e., no cardiopulmonary resuscitation, do no intubate), and patient dies because they did not receive the care based on their limitations. Includes not receiving life-saving surgeries or other interventions (dialysis).
Withdrawal of life support for perceived poor neurologic prognosis	Cessation or removal of ongoing medical therapy for reasons including poor neurologic prognosis (e.g., discussion of “brain injury,” “long-term function,” low chance of awakening from coma, etc.), with the intent not to substitute equivalent alternative therapy. Fully anticipated that the patient will die following the cessation of therapy.
Withdrawal of life support for non-neurologic reasons	Cessation or removal of ongoing medical therapy for systemic (nonbrain) problems (e.g., long-term need for dialysis, multisystem organ failure not predicted to recover, acute or chronic respiratory failure, or heart failure, etc.), with the intent not to substitute equivalent alternative therapy. Fully anticipated that the patient will die following the cessation of therapy.
Brain death	Death by neurologic criteria. No care is actively withdrawn before death pronouncement.