A Small Conversation about a Big Decision

Surrogate decision-makers take longer to decide to forgo life support if they haven't talked with their loved ones

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) New research shows that surrogate decision-makers who had not discussed life support measures with their critically ill family members have more trouble making the final judgement.

Researchers from the University of Pittsburgh School of Medicine and the Graduate School of Public health found that family caregivers were likely to take as much as two weeks longer to decide to end further medical treatment for their family members on life support. In addition, the researchers observed greater levels of confidence in those family caregivers who considered their communication with intensive care physicians to be of high quality.

Between 2005 and 2008, researchers surveyed 230 surrogate decision-makers of critically ill patients with more than a 50 percent chance of dying from their health complications. They found that surrogates who had not talked to patients about their end-of-life preferences lacked confidence in making decisions. In fact, it took them 40 percent longer to decide to forgo life support compared to those who had a conversation.

Lengthening the process of dying may not be advantageous to the patient or to hospitals. According to Douglas B. White, M.D., M.A.S., associate professor and director of the Program on Ethics and Decision-Making in Critical Illness at the University of Pittsburgh, prolonging the dying process is a huge burden to the health care system. not to mention the emotional toll on decision makers. He concludes that the findings from his team's study show that informal family conversations about end-of-life decisions may lighten this burden in addition to relieving some of the stress with which surrogates are faced.

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Review Date: 
January 19, 2011
Last Updated:
January 20, 2011