Beyond substituted judgment: How surrogates navigate end-of-life decision-making.

Beyond substituted judgment: How surrogates navigate end-of-life decision-making. Research Abstract Details 

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Beyond substituted judgment: How surrogates navigate end-of-life decision-making. Abstract Text:

Elizabeth K Vig,Janelle S Taylor,Helene Starks,Elizabeth K Hopley,Kelly Fryer-Edwards,

OBJECTIVES: To characterize how surrogates plan to make medical decisions for others. DESIGN: Descriptive study using semistructured qualitative interviews. SETTING: Surrogates were interviewed by telephone from their homes. PARTICIPANTS: Fifty experienced surrogate decision-makers identified to make decisions for older, chronically ill veterans. MEASUREMENTS: Surrogates were asked to describe advance care planning conversations with loved ones and how they planned to make future medical decisions. Thematic content analysis was used to identify bases for decision-making. RESULTS: Surrogates described the motivators and the content of advance care planning conversations with loved ones. Surrogates described five bases for decision-making: (1) conversations (making decisions based on their knowledge of their loved ones' preferences), (2) relying on documents (referring to their loved ones' advance care directives), (3) shared experience (believing an "inner sense" would guide decisions because of shared lived experience with loved ones), (4) surrogates' own values and preferences about life, and (5) surrogates' network (enlisting the help of others). CONCLUSION: Although ethicists and clinicians expect surrogates to use substituted judgment or patients' best interests when making decisions, these data indicate that many surrogates rely on other factors such as their own best interests or mutual interests of themselves and the patient or intend to base substituted judgments on documents with which they have little familiarity.

Beyond substituted judgment: How surrogates navigate end-of-life decision-making. Publishing Authors By Initials

EK Vig,JS Taylor,H Starks,EK Hopley,K Fryer-Edwards,

For similar persons: veterans research abstracts see: persons: veterans research

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Beyond substituted judgment: How surrogates navigate end-of-life decision-making. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: Journal of the American Geriatrics Society

VOLUME: 54

Page Numbers: 1688-93

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ISSN: 0002-8614

DAY: 3

MONTH: Nov

YEAR: 2006

Beyond substituted judgment: How surrogates navigate end-of-life decision-making. Information

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LANGUAGE: eng

NlmUniqueID: 7503062

Beyond substituted judgment: How surrogates navigate end-of-life decision-making. Keywords Mesh Terms:

KEYWORDS: Veterans

MESH TERMS: methods

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Grant and Affiliation Information for Beyond substituted judgment: How surrogates navigate end-of-life decision-making.

AFFILIATION: Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, Washington, USA. vigster@u.washington.edu

Country: United States

AGENCY: United States NIA

GRANT: K23 AG19635

ACRONYM: AG

MEDLINETA: J Am Geriatr Soc

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