Goals of Care and Quality of Life: Defining What Matters Most

These conversations can feel abstract until they’re made concrete — clarifying what actually matters most helps guide real medical decisions.

What are “goals of care,” exactly?

Goals of care are the specific priorities that guide medical decision-making for someone with a serious illness. Common examples include:

• Prioritizing treatments aimed at extending life, even if aggressive or uncomfortable
• Prioritizing comfort and quality of life over length of life
• Seeking a balance - pursuing some treatment while also protecting comfort and daily function

None of these is more “correct” than another - this is a deeply personal decision.

How is “quality of life” actually defined?

There’s no universal definition. For some people, quality of life means being able to think clearly and communicate with family. For others, it means being at home rather than in a hospital. For others, it means being as free from pain as possible, even if that requires more sedation. Understanding what specifically matters to a particular person - rather than assuming - is the actual goal here.

Can goals of care change over time?

Yes - and this is common and expected. As an illness progresses, or as circumstances change, it’s common and expected to revisit these conversations and adjust - this isn’t a sign of indecision, it’s a normal part of the process.

Who should be involved in defining goals of care?

Ideally the person themselves, their medical team, and close family. If the person can no longer communicate their own wishes, their designated healthcare proxy takes the lead, guided by whatever the person previously expressed - which is exactly why documenting wishes in advance (see our Planning Ahead guides) matters so much.

For one choice some people consider, see what is medical aid in dying.

This is general educational information. Please have these conversations directly with the medical team involved in a specific person’s care.