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This qualitative systematic review searched four databases through November 2025 and conducted citation tracking. Thematic synthesis was performed, and confidence in findings was assessed using GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research). Twelve studies involving 212 healthcare professionals were included. Two analytical and six descriptive themes were identified. Healthcare professionals sought to minimize treatment-related harm while respecting patients\u2019 values and life perspectives. Decision-making was shaped by clinical judgment integrating geriatric assessment findings, healthcare professionals\u2019 perspectives, ethical considerations regarding beneficence and autonomy, and structural factors such as resource limitations and interprofessional collaboration. 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