Format

Send to

Choose Destination
See comment in PubMed Commons below
J Gen Intern Med. 1993 Jul;8(7):361-8.

Life-sustaining treatments during terminal illness: who wants what?

Author information

1
Sheps Center for Health Services Research, University of North Carolina, Chapel Hill 27599-7490.

Abstract

OBJECTIVE:

To determine patient characteristics associated with the desire for life-sustaining treatments in the event of terminal illness.

DESIGN:

In-person survey from October 1986 to June 1988.

SETTING:

13 internal medicine and family practices in North Carolina.

PATIENTS:

2,536 patients (46% of those eligible) aged 65 years and older who were continuing care patients of participating practices, enrolled in Medicare. The patients were slightly older than the 65+ general population, 61% female, and 69% white, and most had one or more chronic illnesses.

MEASUREMENTS AND MAIN RESULTS:

The authors asked the patients whether they would want each of six different treatments (hospitalization, intensive care, cardiopulmonary resuscitation, surgery, artificial ventilation, or tube feeding) if they were to have a terminal illness. The authors combined responses into three categories ranging from the desire for more treatment to the desire for less treatment. After adjustment for other factors, 53% of women chose less treatment compared with 43% of men; 35% of blacks vs 15% of whites and 23% of the less well educated vs 15% of the better educated expressed the desire for more treatment. High depression scores also were associated with the desire for more treatment (26% for depressed vs 18% for others).

CONCLUSION:

Patients' choices for care in the event of terminal illness relate to an intricate set of demographic, educational, and cultural factors. These results should not be used as a shortcut to determine patient preferences for care, but may provide new insights into the basis for patients' preferences. In discussing choices for future life-sustaining care, physicians need to explore with each individual the basis for his or her choices.

PMID:
8410396
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Loading ...
    Support Center