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

ffered 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 T
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End-of-Life Advice Not Always Welcome
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