Journal ArticleDOI
Proxy decision making for incompetent patients. An ethical and empirical analysis.
Reads0
Chats0
TLDR
Ethical and empirical doubts about whether proxies can select interventions that the patient would have selected confront us just as there is a growing need to develop policies on this issue.Abstract:
RECENTLY, proxy or surrogate decision making regarding the termination of life-sustaining interventions for incompetent patients has been widely endorsed and promoted. After theCruzandecision and the Patient Self-Determination Act of 1990, many states enacted proxy statutes specifically for health care. Indeed, even states such as New York and Massachusetts, which in the past had avoided enacting any legislation on living wills and securing the rights of patients, have quickly adopted See also pp 2082 and 2101. health care proxy laws. Simultaneously with this growing enthusiasm for proxy decision making have arisen ethical and empirical doubts about whether proxies can select interventions that the patient would have selected. These divergent trends confront us just as there is a growing need to develop policies on this issue. Consequently, it is important to examine several questions on proxy decision making: How widely endorsed is proxy decision making? What is the justification ofread more
Citations
More filters
Journal ArticleDOI
The Accuracy of Surrogate Decision Makers: A Systematic Review
TL;DR: Data undermine the claim that reliance on surrogates is justified by their ability to predict incapacitated patients' treatment preferences and should assess whether reliance on patient-designated and next-of-kin surrogates offers patients and/or their families benefits that are independent of the accuracy of surrogates' decisions.
Journal ArticleDOI
American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer
Robert C. Smallridge,Kenneth B. Ain,Kenneth B. Ain,Sylvia L. Asa,Sylvia L. Asa,Keith C. Bible,James D. Brierley,James D. Brierley,Kenneth D. Burman,Electron Kebebew,Nancy Y. Lee,Yuri E. Nikiforov,M. Sara Rosenthal,Manisha H. Shah,Ashok R. Shaha,R. Michael Tuttle +15 more
TL;DR: These are the first comprehensive guidelines for ATC and provide recommendations for management of this extremely aggressive malignancy.
Journal ArticleDOI
Advance Directives as Acts of Communication A Randomized Controlled Trial
Peter H. Ditto,Joseph H. Danks,William D. Smucker,Jamila Bookwala,Kristen M. Coppola,Rebecca Dresser,Angela Fagerlin,Robert Gready,Renate Houts,Lisa K. Lockhart,S. Zyzanski +10 more
TL;DR: The results challenge current policy and law advocating instructional advance directives as a means of honoring specific patient wishes at the end of life and suggest other methods of improving surrogate decision making should be explored.
Journal ArticleDOI
Postoperative delirium in the elderly.
Smita S. Parikh,Frances Chung +1 more
TL;DR: The geriatric-anesthesiologic intervention program of pre- and postoperative geriatric assessment, early surgery, thrombosis prophylaxis, oxygen therapy, prevention and treatment of perioperative decrease in blood pressure, and vigorous treatment of any postoperative complications showed some promise, but further definitive studies are needed.
References
More filters
Journal ArticleDOI
The measurement of observer agreement for categorical data
J. R. Landis,Gary G. Koch +1 more
TL;DR: A general statistical methodology for the analysis of multivariate categorical data arising from observer reliability studies is presented and tests for interobserver bias are presented in terms of first-order marginal homogeneity and measures of interob server agreement are developed as generalized kappa-type statistics.
Journal ArticleDOI
Advance Directives for Medical Care — A Case for Greater Use
TL;DR: Advance directives as part of a comprehensive approach such as that provided by the Medical Directive are desired by most people, require physician initiative, and can be achieved during a regular office visit.
Journal ArticleDOI
Substituted judgment: how accurate are proxy predictions?
TL;DR: Results cast doubt on the usefulness of a strict substituted judgment standard as an approach to medical decision making for patients with diminished mental capacity.
Journal ArticleDOI
A prospective study of advance directives for life-sustaining care.
Marion Danis,L. I. Southerland,Joanne M. Garrett,J. L. Smith,F. Hielema,C. G. Pickard,D. M. Egner,Donald L. Patrick +7 more
TL;DR: The effectiveness of written advance directives is limited by inattention to them and by decisions to place priority on considerations other than the patient's autonomy.
Journal ArticleDOI
Physicians' and spouses' predictions of elderly patients' resuscitation preferences.
TL;DR: Physicians and spouses often do not understand elderly outpatients' resuscitation preferences, and under these circumstances they are unlikely to provide accurate substituted judgments.