0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Stability of Choices about Life-Sustaining Treatments

Marion Danis, MD; Joanne Garrett, PhD; Russell Harris, MD; and Donald L. Patrick, PhD
[+] Article and Author Information

From the University of North Carolina, Chapel Hill, North Carolina, and the University of Washington, Seattle, Washington. Requests for Reprints: Marion Danis, MD, Division of General Medicine, Department of Medicine, CB #7110, 5025A Old Clinic Building, University of North Carolina, Chapel Hill, NC 27599-7110. Grant Support: In part by a cooperative research agreement (95-C-98516/4) between the Health Care Financing Administration and the Department of Social Medicine, School of Medicine at the University of North Carolina at Chapel Hill, in collaboration with the Cecil G. Sheps Center for Health Services Research. The views expressed are those of the authors and do not necessarily reflect the opinions of the Health Care Financing Administration.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1994;120(7):567-573. doi:10.7326/0003-4819-120-7-199404010-00006
Text Size: A A A

Objective: To examine the stability of patients' choices for life-sustaining treatments.

Design: A longitudinal cohort study.

Setting: Primary care practices in central North Carolina.

Patients: Medicare recipients (n = 2536).

Intervention: Participants were asked about demographic characteristics, health status, well-being, depression, social support, use of a living will, and desire for life-sustaining treatments if they were to become terminally ill. These questions were repeated 2 years later (n = 2073, 82% follow-up).

Results: The population tended to choose to forego one more treatment at follow-up than they did at baseline. A choice to forego treatment was twice as stable as a choice to receive treatment. Patients with a living will were less likely to change their wishes (14%) than those without a living will (41%). Persons were more likely to want increased treatment at a later time if they had been hospitalized (23% compared with 18%), had had an accident (29% compared with 19%), had become more immobile (23% compared with 19%), had become more depressed (25% compared with 15%), or had less social support (25% compared with 14%).

Conclusions: Most patients (85%) who had chosen to forego life-sustaining treatments did not change their choices. Nonetheless, these data suggest that it is important to review patients' preferences for life-sustaining treatments rather than to assume the stability of their choices.

Figures

Grahic Jump Location
Figure 1.
Frequency distribution of the stability of treatment preference scores.

The stability was calculated by subtracting the follow-up Treatment Preference Scale score from the baseline Treatment Preference Scale score.

Grahic Jump Location

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)