2006
DOI: 10.1177/0272989x06290494
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Context Changes Choices: A Prospective Study of the Effects of Hospitalization on Life-Sustaining Treatment Preferences

Abstract: Preferences for life-sustaining treatment are dependent on the context in which they are made, and thus individuals may express different treatment preferences when they are healthy than when they are ill. These results challenge a key psychological assumption underlying the use of instructional advance directives in end-of-life decision making.

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Cited by 139 publications
(114 citation statements)
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“…15 Individuals may have different treatment preferences when they are healthy to those when they are ill and, as a consequence, choices about what treatment is desirable and acceptable may change over the course of their illness. 16,17 Although GPs are well positioned to initiate ACDs due to their ongoing relationship with their patients, how such information is consistently shared across health care settings remains problematic. Numerous approaches to sharing ACDs have been investigated both in Australia and internationally, but there has been limited universal uptake due to a lack of systematic processes for embedding them into routine practice at an institutional level and across health jurisdictions.…”
Section: Discussionmentioning
confidence: 99%
“…15 Individuals may have different treatment preferences when they are healthy to those when they are ill and, as a consequence, choices about what treatment is desirable and acceptable may change over the course of their illness. 16,17 Although GPs are well positioned to initiate ACDs due to their ongoing relationship with their patients, how such information is consistently shared across health care settings remains problematic. Numerous approaches to sharing ACDs have been investigated both in Australia and internationally, but there has been limited universal uptake due to a lack of systematic processes for embedding them into routine practice at an institutional level and across health jurisdictions.…”
Section: Discussionmentioning
confidence: 99%
“…2,16,17 This concern is based on the findings that patients with declining health have been shown, when asked about hypothetical future situations, to become more accepting of life-sustaining treatment. 18 Such findings support the notion that, as patients adapt to their declining health, they become more willing to undergo interventions to maintain that health state and/or to accept further diminishing states of health.…”
Section: Changes In and Variability Of Preferences At The Very End Ofmentioning
confidence: 99%
“…Our major findings are unchanged under this interpretation, yet we prefer it because statements of preference are often unreliable. In the course of an actual medical decision-making process, patients' expressed preferences change over time and vary with circumstances Ditto et al 2006;Kressel and Chapman 2007;Loewenstein 2005). …”
Section: Model-the Structural Equations Describing the Model Arementioning
confidence: 99%
“…Thus spouses in opposite sex marriages may differ in their end-of-life preferences, and assuming similarity may result in problematic health care decisions by both male and female surrogates. Our results suggest that male surrogates are as poor at predicting their wives' preferences as female surrogates are at predicting their husbands' preferences.Second, prior research has documented that end-of-life preferences vary with health status (Ditto et al 2006;Fried et al 2007;Voogt et al 2005). The sicker the patient, the less likely he or she is to prefer continued curative treatment.…”
mentioning
confidence: 99%