Navigation Links
End-of-Life Advice Not Always Welcome
Date:8/25/2009

Many relatives want doctors to keep their opinions to themselves, study finds

TUESDAY, Aug. 25 (HealthDay News) -- When deciding whether to turn off life support for a loved one, family members aren't always interested in their doctor's advice, new research shows.

The finding runs counter to assumptions among critical-care providers that families making such a heart-wrenching choice would welcome a physician's impartial opinion.

Critically ill patients who don't have advance directives often require others to make medical decisions for them, said study author Douglas B. White, of the University of Pittsburgh Medical Center.

Family members often make the decision based on what they believe the patient would have wanted.

"This puts an enormous emotional burden on surrogates; not only are they losing a loved one, they also may feel burdened by guilt about allowing the patient to die," White said. "It was therefore assumed by some in the medical community that a doctor's dispassionate advice could reduce some of that burden and help surrogates make a good decision with less second-guessing themselves."

Researchers showed videos to 169 surrogates recruited from intensive care units at University of California San Francisco Medical Center. The videos depicted a dramatized "family conference" in which surrogates must decide whether to withdraw life support from a loved one who has a small chance of survival with continued treatment, but a high likelihood of being functionally impaired and needing a ventilator.

In one video, the doctor tells the surrogate to make the choice that's consistent with the patient's values, and that only the surrogate knows what that is. In the second video, the doctor tells the surrogate that the patient probably wouldn't want continued attempts to keep him or her alive.

About 56 percent of surrogates said they preferred the video in which the physician offered an opinion to limit life support, while 42 percent preferred the video in which no recommendation was offered. Two percent had no preference.

The study appears in the August 15 issue of the American Journal of Respiratory and Critical Care Medicine.

Dr. J. Randall Curtis, president of the American Thoracic Society, said the paper challenges current assumptions about dealing with families in end-of-life situations.

"This is an important article that has changed my clinical practice," said Curtis, a professor of medicine and section head of pulmonary and critical care medicine at Harborview Medical Center in Seattle. "I had previously assumed that almost all families would want physicians' recommendations, but these findings indicate that there is no such consensus among surrogates. I suspect that physicians can do more harm by withholding a recommendation that is desired than by providing a recommendation that is not desired, but this study suggests we should ask rather than assume."

About 51 percent of the surrogates who wanted their doctor's advice believed that it was the doctor's job to provide that opinion. Nearly 79 percent who preferred not to receive the advice saw it as overstepping.

"A very important part of American bioethics is respecting patients' choices," White said. "The family's most important job when acting as a surrogate decision maker is to give voice to the patient's values. I think our research highlights that the physician's job is to be flexible enough and insightful enough to respond to the surrogate's individual needs for guidance."

More information

The Family Caregiver Alliance has more on making end-of-life decisions.



-- Jennifer Thomas



SOURCE: American Thoracic Society, news release, August 2009


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Breaking Down Barriers to End-of-Life Care for Children
2. New UIC center to study end-of-life transition
3. Doctors Review End-of-Life Care Guidelines
4. Interview by Internet Can Decrease Greatest End-of-Life Fears: It Facilitates Creating Effective Advance Directives, Living Wills
5. National Healthcare Decisions Survey: Its Easier to Talk About Drugs and Sex Than End-of-Life Planning
6. Study shows false memories complicate end-of-life treatment decisions
7. Circle of Life Awards Recognize Innovative End-of-Life Care Providers
8. Patients Benefit From End-of-Life Discussions With a Doctor
9. Seniors Tend to Stick With End-of-Life Care Preferences
10. Doctors questions about end-of-life legalities may result in patient pain
11. Unique Planning Guide Helps Professionals and Families Through Healthcare and End-of-Life Decision Making
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
End-of-Life Advice Not Always Welcome
(Date:3/29/2017)... ... , ... CHARM CITY RUN WELCOMES MERCY MEDICAL CENTER AS , BALTIMORE WOMEN’S ... serve as the official title sponsor of the Baltimore Women’s Classic, the largest all ... women will walk or run the course around the Baltimore Inner Harbor. Mercy has ...
(Date:3/29/2017)... ... March 29, 2017 , ... Wells Pharmacy Network, a ... at the upcoming World Congress, in Hollywood Florida April 6-8, 2017. , Ben ... the visionary leader in the training of physicians, scientists, and members of the ...
(Date:3/29/2017)... ... March 29, 2017 , ... ... FASTBRACES® in Carnegie, OK, from Dr. Jamie Cameron, with or without a ... compared to traditional orthodontic treatment. Depending on each patient’s case, treatment with the ...
(Date:3/29/2017)... ... March 29, 2017 , ... Altima Technologies, Inc., the ... and data center assets and audio-video devices has recently updated its Visio Stencils ... for free and download shapes and stencils from http://www.VisioStencils.com. , New ...
(Date:3/29/2017)... Yorba Linda, Ca (PRWEB) , ... March 29, ... ... a standard process in many scientific laboratories. The assembly protocols involve many repetitive ... is well suited for automation, which enables the high-throughput needed, and results in ...
Breaking Medicine News(10 mins):
(Date:3/29/2017)... DUBLIN , Mar. 29, 2017 Research and ... Market, Reimbursement Policy, Patients Treated at Proton Therapy Centers & Forecast" ... ... 2021 from its current market size in 2016. The Untapped Proton Therapy ... than 1 Billion USD in 2016. Proton Therapy plays ...
(Date:3/29/2017)... 2017  Zynex (OTCQB: ZYXI), an innovative medical technology company ... devices for pain management, stroke rehabilitation, cardiac monitoring and ... Company,s 2016 full-year investor webcast on Monday, April 3, 2017 at 9:00 ... Company expects to file its 2016 full year financial ... ...
(Date:3/29/2017)... March 29, 2017 According to a new market ... (Gas-Filled Detectors, Geiger Muller, Survey Meter, Solid-State), Products (Personal Dosimeters, OSL, Badges), ... published by MarketsandMarkets, the market is expected to reach USD 1,215.4 Million ... 6.5% from 2016 to 2021. Continue Reading ... ...
Breaking Medicine Technology: