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- Bioethical frameworks in end of life care decision-makingPublication . Pereira, Sandra Martins; Borges, Paulo J.; Hernández-Marrero, PabloThis chapter provides an overview of how the medicalisation of dying and increasing access to high-technology interventions at the end of life have led to multiplying ethical challenges in decision-making in biomedical settings around the world. Bioethical frameworks and models exist to aid healthcare professionals and teams in navigating complex ethico-clinical decision-making processes. Five different frameworks are described. While embracing a person-centred care approach and with relational autonomy as a guiding ethical principle, healthcare professionals and family members play a crucial role in shared decision-making processes. Promoting dignity, comfort, and peace is crucial to ensuring that decision-making processes are truly shared and end of life care aligns with patients’ cultural beliefs, values, wishes, and preferences. Ethical and conceptual issues surrounding bioethical challenges in palliative and end of life care require ongoing analyses to respond adequately to the diverse needs of changing societies.