© 1989 The Gerontological Society of America
Treatment Choices at the End of Life: A Comparison of Decisions by Older Patients and Their Physician-Selected Proxies1
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Abstract |
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Doctors are increasingly faced with the ethical dilemma of making end-of-life medical care decisions for older patients who are decisionally incapacitated. Most often, they rely on family to assist them in choosing what the patient would have wanted. In this vignette-based study, the ability of proxies to choose as the patients reported they would have chosen is called into question. Implications for the use of advance directives for end-of-life care and avenues for needed research are discussed.
Keywords: Medical ethics, Surrogates, Advance directives, Decision-making, Life-sustaining treatment
1 This research was supported by a grant from the AARP Andrus Foundation. The authors wish to thank Greg A. Sachs, M.D., and Bernice Neugarten, Ph.D., D.Sc. for their thoughtful reviews of an earlier draft of this paper. We also wish to thank Janese Beckwith and Eric Westfried for their work in data collection.
2 Nancy R. Zweibel is Research Associate (Instructor) and Director of Research in Geriatrics and Gerontology, and Christine K. Cassel is Associate Professor and Chief of the Section of General Internal Medicine at the University of Chicago Department of Medicine, 5841 South Maryland Avenue, Box 72, Chicago, IL 60637.
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