Used in the United Kingdom, treatment escalation/limitation plans (TELPs; similar to advanced directives and other end-of-life care plans used in the United States) are intended to minimize harm by setting individualized treatment limits in the event of acute deterioration. This retrospective case-control study set in three UK hospitals explored whether the use of TELPs was associated with reductions in non-beneficial interventions, harms, and complaints about end-of-life care from next of kin. Over a three-year period, 59 complaints were received by the three included hospitals. The authors found patients at end-of-life whose next-of-kin submitted a complaint received poor care (higher rates of non-beneficial interventions and harms) compared to controls. The authors did not identify any difference between complaint cases who did or did not have a TELP.