Featured Research

from universities, journals, and other organizations

How Do Doctors Really Feel About Surrogate Decision Making?

Date:
September 8, 2009
Source:
Indiana University
Summary:
A recent study found that one in five doctors are not comfortable working with a surrogate decision maker. The doctors surveyed reported ineffective communication, lack of satisfaction with the outcome of the decision, and an increase in stress level as a result of the surrogate decision making process.

A growing number of hospitalized adults are incapable of making their own health decisions, but little research has explored how doctors feel about making medical decisions with a patient's surrogate decision maker.

A study published in the September 2009 issue of the Journal of General Internal Medicine found that one in five doctors are not comfortable working with a surrogate decision maker. The doctors surveyed reported ineffective communication, lack of satisfaction with the outcome of the decision, and an increase in stress level as a result of the surrogate decision making process.

"We have come to consensus in our society that people should have a lot of input into their own medical decisions. But when the patient can't made decisions we have much less consensus on how to proceed. For example, we aren't as certain if the family should have as much discretion as patients would if they could make their own decisions or if the physicians should assume some of the responsibility," said Alexia Torke, M.D., senior author of the study. Dr. Torke is assistant professor of medicine at the Indiana University School of Medicine and a Regenstrief Institute investigator.

A surrogate decision maker often becomes involved in the care process only after the patient is critically ill and concerns are being raised about the futility of continued medical care and the value of life. These are very difficult issues for both physician and surrogates and often ones which neither party discussed with the patient when that individual was still competent to make decisions about care preferences.

The study surveyed 281 doctors, primarily internists, family practice doctors, intensive care unit physicians and hospitalists, about half of whom were in private practice. Slightly over half were male. Three-quarters of the physicians reported having made a major decision with a surrogate during the past month. Most of these surrogate decisions involved some aspect of life sustaining care for older adults. A quarter of the doctors stated that surrogate decision making caused them a great deal of distress.

"A significant percentage of decisions faced by surrogates involve changing aggressive care to comfort care, when medical options have been exhausted. Making a decision to change the focus of therapy is often a very difficult one for the surrogate, who may be a close family member and under a great deal of stress due to the patient's illness. Often, neither the physician nor the family knows what course of treatment the patient would have elected. Physicians reported that they also feel significant distress when make these decisions," said Dr. Torke, who is also with the Fairbanks Center for Medical Ethics at Clarian Health.

She notes that although only a small percent of patients lacked an identified surrogate, physicians often had trouble reaching the surrogate to make critical decisions. Additionally, few patients had ever expressed prior written or oral preferences for care.

Asian physicians, who comprised 28 percent of the doctors surveyed, were less likely to report agreement with surrogates than white or African American physicians. The study did not differentiate between American born and foreign born Asian physicians who may have experience language difficulties in communicating with surrogate decision makers. Dr. Torke says further research is needed to explore why Asian doctors reached lower levels of agreement with surrogate decision makers.

The JGIM study was funded by the Department of Health and Human Services' Health Resources Services Administration. Co-authors are Mark Siegler, M.D., Rachael M. Moloney, B.A., and G. Caleb Alexander, M.D., of the University of Chicago, and Anna Abalos, M.D., of West Suburban Hospital, Oak Park, Ill.


Story Source:

The above story is based on materials provided by Indiana University. Note: Materials may be edited for content and length.


Cite This Page:

Indiana University. "How Do Doctors Really Feel About Surrogate Decision Making?." ScienceDaily. ScienceDaily, 8 September 2009. <www.sciencedaily.com/releases/2009/09/090908124633.htm>.
Indiana University. (2009, September 8). How Do Doctors Really Feel About Surrogate Decision Making?. ScienceDaily. Retrieved August 21, 2014 from www.sciencedaily.com/releases/2009/09/090908124633.htm
Indiana University. "How Do Doctors Really Feel About Surrogate Decision Making?." ScienceDaily. www.sciencedaily.com/releases/2009/09/090908124633.htm (accessed August 21, 2014).

Share This




More Health & Medicine News

Thursday, August 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Newsy (Aug. 21, 2014) An experimental drug used to treat Marburg virus in rhesus monkeys could give new insight into a similar treatment for Ebola. Video provided by Newsy
Powered by NewsLook.com
Cadavers, a Teen, and a Medical School Dream

Cadavers, a Teen, and a Medical School Dream

AP (Aug. 21, 2014) Contains graphic content. He's only 17. But Johntrell Bowles has wanted to be a doctor from a young age, despite the odds against him. He was recently the youngest participant in a cadaver program at the Indiana University NW medical school. (Aug. 21) Video provided by AP
Powered by NewsLook.com
American Ebola Patients Released: What Cured Them?

American Ebola Patients Released: What Cured Them?

Newsy (Aug. 21, 2014) It's unclear whether the American Ebola patients' recoveries can be attributed to an experimental drug or early detection and good medical care. Video provided by Newsy
Powered by NewsLook.com
Lost Brain Cells To Blame For Sleep Problems Among Seniors

Lost Brain Cells To Blame For Sleep Problems Among Seniors

Newsy (Aug. 21, 2014) According to a new study, elderly people might have trouble sleeping because of the loss of a certain group of neurons in the brain. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins