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Most Health Proxies Would Make End-of-Life Decisions Themselves: Study
Date:10/29/2010

FRIDAY, Oct. 29 (HealthDay News) -- More than half of the surrogate decision makers for incapacitated or critically ill patients want to have full control over life-support choices and not share or yield that power to doctors, finds a new study.

It included 230 surrogate decision makers for incapacitated adult patients dependent on mechanical ventilation who had about a 50 percent chance of dying during hospitalization. The decision makers completed two hypothetical situations regarding treatment choices for their loved ones, including one about antibiotic choices during treatment and another on whether to withdraw life support when there was "no hope for recovery."

The study found that 55 percent of the decision makers wanted to be in full control of "value-laden" decisions, such as whether and when to withdraw life support during treatment. Another 40 percent wanted to share such decisions with physicians, and only 5 percent wanted doctors to assume full responsibility.

Trust in the physicians overseeing their loved one's care was a significant factor influencing the extent to which decision makers wanted to retain control over life-support decisions, said the University of Pittsburgh School of Medicine researchers.

They also found that men and Catholics were less likely to want to cede their decision-making authority.

"This report suggests that many surrogates may prefer more [control] for value-laden decisions in ICUs than previously thought," study author Dr. Douglas B. White, an associate professor and director of the Program on Ethics and Decision Making in Critical Illness at the University of Pittsburgh, said in an American Thoracic Society news release.

The results indicate the need for a distinction "between physicians sharing their opinion with surrogates and physicians having final authority over those decisions," he added.

The study was published online Oct. 29 in advance of print in the American Journal of Respiratory and Critical Care Medicine.

More information

The U.S. Agency for Healthcare Research and Quality has more about end-of-life treatment decisions.

-- Robert Preidt

SOURCE: American Thoracic Society, news release, Oct. 29, 2010.


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