Medical technologies facilitate by sustaining human lives to reshape the circumstances

surrounding natural death. Although medical treatments are technologically advanced they do
not hold promises of recovery, they can sustain life with or without meaningful existence or
secondary support like ventilators, feeding tubes and many more. These medical advances have
therefore empowered patients and their families or proxies with an important task of selecting
their preferred treatment during end-of-life care. End-of - life care decision-making has gained
paramount importance as it is capable of prolonging human life with the support of medical
technology or allowing the natural process of death to continue by foregoing the treatment
option. End-of - life care therefore faces diverse ethical dilemmas because according to Michele
West, (2014) End-of-life care issues are often complex moral, ethical, or legal dilemmas, or a
combination of these, regarding a patient's vital physiologic functions, medical-surgical
prognosis, quality of life, and personal values and beliefs. The purpose of this synthesis paper is
to discuss issues that influence patients, caregivers and professionals in the care of older adults
such as autonomous decision-making, advance guidelines and care rationing in futile treatments.