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Numerous factors weighed when patients cannot make their own decisions
Date:3/22/2010

INDIANAPOLIS Living wills and surrogate decision makers account for only a portion of the many factors weighed by physicians when making medical decisions for hospitalized patients lacking the capability to make their own decisions, according to a recently published study.

Researchers who queried 281 physicians report their conclusions in a study that appears in the March 2010 issue of the Journal of the American Geriatrics Society.

"A growing number of hospitalized adults are incapable of making their own health decisions," said Alexia Torke, M.D., senior author of the study. "Doctors balance a lot of important considerations when caring for a patient who cannot voice his or her own preferences. These considerations include what the patient would have wanted and what the physician and family think is best for the patient overall. While prior discussions or living wills may be helpful especially in circumstances when the patient expressed strong beliefs and is facing a difficult illness, these preferences are only part of the equation." Dr. Torke is an assistant professor of medicine at the Indiana University School of Medicine, a Regenstrief Institute investigator, and an IU Center for Aging Research scientist.

The study surveyed 281 internists, family practice doctors, intensive care unit physicians and hospitalists, about half of whom were in private practice. Slightly over half were male. Each was asked questions about caring for their most recent patient who was unable to make his or her own decisions and rated the importance of each of the factors that influenced decisions on how to care for the patient.

The researchers found that when asked to identify the single most important factor in making decisions for their patient, physicians most commonly reported "what was best for the patient overall" (33 percent), "what the patient would have wanted you to do" (29 percent), "the patient's pain and suffering"
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Contact: Cindy Fox Aisen
caisen@iupui.edu
317-274-7722
Indiana University School of Medicine
Source:Eurekalert  

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