Round one criteria Round one was subdivided in diagnostic criteria, treatment-related criteria and treatment refusal criteria (table 3). Eight of 20 criteria reached consensus, three of which were diagnostic criteria (table 2: A1, A3 and B), five were treatment criteria (table 2: D, E, F, H & I), none of the treatment refusal criteria reached consensus. Three of five diagnostic criteria reached consensus in the first round (table 3). The accompanying comments indicated these criteria were sufficiently clear and that no substantial new viewpoints were introduced in the comments. These were not, therefore, repeated in round two. Two diagnostic criteria that did not reach consensus were included in round two after rephrasing guided by the comments (tables 3 and 4). Of the eight initial treatment criteria, five reached consensus in the first round (table 3). From the comments it was clear that all criteria were understood and these were not repeated in round two. Three other criteria did not reach consensus and were adapted based on participants’ comments and repeated in round two (tables 3 and 4). None of the treatment refusal criteria reached consensus. This appeared to be due to the formulation of the criteria: many participants commented that it is certainly possible that the suffering is irremediable when the patient does not cooperate, but that the irremediability cannot be established in this case. The criteria were reformulated in round two (table 4). A DELPHI STUDY ON IRREMEDIABILITY | 105 6