Escalation of Commitment in Treatment Decisions Near End of Life

To the Editor Knoops and Bastin focus on an important population of patients who have hematological malignant neoplasms with uncertain prognoses and a high chance of suffering from distressing symptoms during the course of their cancer and treatment. Their description of "escalation of commitment" is a fitting paradigm in this population and with this patient-physician dyad. They recommend several strategies to defend against this bias, including clinician self-reflection, discussing risk of treatment failure and alternative approaches even before starting disease modifying therapy, and finally involving a third party such as a palliative care specialist.

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