Create Account | Sign In: Author or Forum

Search Symptoms

Category: Family Medicine | Internal Medicine | Critical Care | Pulmonology | Journal

Back to Journal Articles

Physician Role in End-of-Life Decisions Up to Family

Last Updated: August 13, 2009.

Physicians for incapacitated, critically ill patients should offer to make recommendations to family members acting as surrogate decision-makers on life support issues, understanding that their advice may or may not be desired, according to a study in the Aug. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

THURSDAY, Aug. 13 (HealthDay News) -- Physicians for incapacitated, critically ill patients should offer to make recommendations to family members acting as surrogate decision-makers on life support issues, understanding that their advice may or may not be desired, according to a study in the Aug. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

Douglas B. White, M.D., of the University of California in San Francisco, and colleagues conducted a study in which 169 surrogate decision-makers for gravely ill patients viewed two videos depicting physician--surrogate dialogues about life support issues. The two videos differed only in that in one the physician gave the surrogate a recommendation. The surrogates were asked if they preferred to receive a physician recommendation and were interviewed to discuss their preference.

The researchers found that 56 percent of surrogates preferred to get a physician recommendation, 42 percent did not, and 2 percent found either approach satisfactory. The factors involved in the preference included the surrogate's view of the physician role in end-of-life decisions, the consequences of the recommendation on the relationship between the surrogate and the physician, the risk of long-term regret for the family, and the surrogate's desire to make a decision informed by a medical expert.

"There is no consensus among surrogates about whether physicians should routinely provide a recommendation regarding life support decisions for incapacitated patients. These findings suggest that physicians should ask surrogates whether they wish to receive a recommendation regarding life support decisions and should be flexible in their approach to decision-making," the authors write.

One of the study authors reported receiving payments as an expert witness for a number of law firms.

Abstract
Full Text (subscription or payment may be required)


Previous: Fluoroquinolone Use Spikes Risk of Resistant TB Strain Next: Healthy Lifestyle Helps Prevent Chronic Diseases

Reader comments on this article are listed below. Review our comments policy.


Submit your opinion: