A 78-Year-Old Man with End-Stage Esophageal Cancer Is Admitted to the Hospital

A 78-year-old man with end-stage esophageal cancer is admitted to the hospital with severe malnutrition and failure to thrive.  The patient's caretaker says that he has not been able to eat or drink for the last 3 weeks.  His weight dropped from 72.6 kg (160 lb) to 63.5 kg (140 lb) during that time.  The cancer has spread to his lungs and liver.  The patient does not wish to receive any further treatment for the cancer and specifies that he wants no heroic measures or interventions to keep him alive.  His physician considers referral to hospice care.  Which of the following is a requirement for referring a patient for hospice care?

A) Patient has a diagnosis of end-stage cancer
B) Patient has a do-not-resuscitate order
C) Patient has decision-making capacity
D) Patient has a prognosis of ≤6 months
E) Patient has a prognosis of ≤3 months

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