Combined Action Strategies 1.  Clarify goals of care 2.  Be explicit about connections between particular interventions and goals of care, including non-curative goals of care.  3.  Assess whether all reasonable options have been attempted 4.  Do not offer options that are not medically appropriate 5.  Maintain the distinction between quantitative and qualitative futility 6.  Establish guidelines and limits for interventions in place 7.  Seek to address the emotional needs of the caregiver 8.  Allow for the possibility of reasonable disagreement about whether an intervention is quantitatively futile, and pursue reconciliation of such disagreement on the basis of available facts when possible.

Table 2: Combined Action Strategies.