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| Research article summary (published 27 Feb 2003): |
The seriously ill hospitalized patient: preferred role in end-of-life decision making?
Full Abstract
PURPOSE:
The objective of this study was to further our understanding of the decision-making process near the end of life. Specifically, we ascertained the seriously ill patients' preferred role in the decision-making process, what factors were associated with this role, and how this stated preference related to physicians' perception of preferred role.
MATERIALS AND METHODS:
Prospective cohort study of hospitalized patients with end-stage congestive heart disease, chronic pulmonary disease, cirrhosis, or metastatic cancer. Eligible patients were interviewed to ascertain their personal views on end-of-life decision making, desired role, and level of symptoms experienced.
RESULTS:
A total of 135 patients were enrolled in this study. The majority of patients (103, 76%) had thought about end-of-life issues although only 48 (36%) had discussed them with their doctor in the hospital. With respect to preferred role in decision making, in the scenario of a competent patient, 14 (10%) preferred to leave all decisions to the doctor, 12 (9%) preferred that the doctor make the final decision after considering their opinion, 43 (32%) preferred that the doctor shared responsibility with them to make the decision, 32 (24%) patients preferred to make the final decision after considering the doctor's opinion, 21 (16%) preferred to make the treatment decision alone, and 13 (10%) did not answer. Physicians were not able to accurately predict patient's preferred role nor could the variability in patient choice be accounted for by demographic or symptom covariates.
CONCLUSION:
Seriously ill hospitalized patients desire to discuss end-of-life issues with their physicians but their preferred role in decision making is variable and difficult to predict.Copyright 2003 Elsevier, Inc. All rights reserved.
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Author information
Author/s: Heyland, Daren K (DK); Tranmer, Joan (J); O'Callaghan, C J (CJ); Gafni, Amiram (A);
Affiliation: Department of Medicine, Queen's University, Kingston, Ontario, Canada. dkh2@post.queensu.ca
Journal and publication information
Publication Type: Journal Article; Research Support, Non-U.S. Gov't
Journal: Journal of critical care (J Crit Care), published in United States. (Language: eng)
Reference: 2003-Mar; vol 18 (issue 1) : pp 3-10
Dates: Created 2003/03/17; Completed 2003/07/01; Revised 2006/11/15;
PMID: 12640606, status: MEDLINE (last retrieval date: 11/6/2008)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
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