IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v28y2008i4p524-531.html
   My bibliography  Save this article

Patient and Surrogate Disagreement in End-of-Life Decisions: Can Surrogates Accurately Predict Patients' Preferences?

Author

Listed:
  • Melissa A. Z. Marks

    (Department of Psychology, The Ohio State University, marks.99@osu.edu)

  • Hal R. Arkes

    (Department of Psychology, The Ohio State University, Division of Health Services, Management, and Policy, The Ohio State University, The Center for Health Outcomes, Policy, and Evaluation Studies (HRA), The Ohio State University, Columbus)

Abstract

Background . When a patient is too incapacitated to make important end-of-life decisions, doctors may ask a preappointed surrogate to predict the patient's preferences and make decisions on the patient's behalf. The current study investigates whether surrogates project their own views onto what they predict the patients' preferences are. Methods . Using data from seriously ill patients and their surrogates, the authors created a ``projection'' variable that addresses the following question: When surrogates are asked to predict a patient's end-of-life preferences, do they mistakenly replace this prediction with what they would want the patient to do? The authors examined the 144 patient-surrogate pairs in which surrogates inaccurately predicted patients' CPR (cardiopulmonary resuscitation) v. DNR (do not resuscitate) decisions and the 294 pairs in which surrogates inaccurately predicted patients' extend life v. relieve pain preferences. Among these patient-surrogate pairs, the authors determined the extent to which surrogates' wishes for the patient matched their incorrect predictions of what the patient wanted. Results. Of the patient-surrogate pairs who disagreed on CPR v. DNR and extend life v. relieve pain preferences, 62.5% and 88.4% of surrogates demonstrated projection for CPR v. DNR decisions and extend life v. relieve pain preferences, respectively. Age-related and demographic variables did not predict cases in which projection did and did not occur. Conclusion. When surrogates inaccurately predict the CPR v. DNR and extend life v. relieve pain preferences of seriously ill, hospitalized loved ones, surrogates' prediction errors often represent surrogates' own wishes for the patient.

Suggested Citation

  • Melissa A. Z. Marks & Hal R. Arkes, 2008. "Patient and Surrogate Disagreement in End-of-Life Decisions: Can Surrogates Accurately Predict Patients' Preferences?," Medical Decision Making, , vol. 28(4), pages 524-531, July.
    • Handle: RePEc:sae:medema:v:28:y:2008:i:4:p:524-531
    DOI: 10.1177/0272989X08315244
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X08315244
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X08315244?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Jay J.J. Christensen-Szalanski, 1984. "Discount Functions and the Measurement of Patients' Values," Medical Decision Making, , vol. 4(1), pages 47-58, February.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Paul Dolan & Claire Gudex, 1995. "Time preference, duration and health state valuations," Health Economics, John Wiley & Sons, Ltd., vol. 4(4), pages 289-299, July.
    2. Jonathan R. Treadwell & Leslie A. Lenert, 1999. "Health Values and Prospect Theory," Medical Decision Making, , vol. 19(3), pages 344-352, August.
    3. Eike Kroll & Judith Trarbach & Bodo Vogt, 2012. "Do people have a preference for increasing or decreasing pain? An experimental comparison of psychological and economic measures in health related decision making," FEMM Working Papers 120012, Otto-von-Guericke University Magdeburg, Faculty of Economics and Management.
    4. Milton C. Weinstein, 1986. "Challenges for Cost-effectiveness Research," Medical Decision Making, , vol. 6(4), pages 194-198, December.
    5. Neuman, Einat & Neuman, Shoshana, 2006. "Explorations of the Effect of Experience on Preferences: Two Health-Care Case Studies," IZA Discussion Papers 2028, Institute of Labor Economics (IZA).
    6. Paul Dolan & Claire Gudex & Paul Kind & Alan Williams, 1996. "The time trade‐off method: Results from a general population study," Health Economics, John Wiley & Sons, Ltd., vol. 5(2), pages 141-154, March.
    7. Ola Svenson & Gunnar Karlsson, 1989. "Decision‐Making, Time Horizons, and Risk in the Very Long‐Term Perspective," Risk Analysis, John Wiley & Sons, vol. 9(3), pages 385-399, September.
    8. BEJEAN, Sophie & MIDY, Fabienne & PEYRON, Christine, 1999. "La rationalité simonienne : Interprétations et enjeux épistémologiques," LATEC - Document de travail - Economie (1991-2003) 1999-14, LATEC, Laboratoire d'Analyse et des Techniques EConomiques, CNRS UMR 5118, Université de Bourgogne.
    9. G. Ardine De Wit & Jan J.V. Busschbach & Frank Th. De Charro, 2000. "Sensitivity and perspective in the valuation of health status: whose values count?," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 109-126, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:28:y:2008:i:4:p:524-531. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.