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Making health decisions for others not easy on surrogate
Study shows that burden lasts for years
Clinicians rely upon family members or other surrogates to make health decisions, such as entering hospice care, when an adult patient is incapacitated. A study published in the Annals of Internal Medicine evaluates the effect of this practice on the surrogates.1
Authors reviewed previous studies that included information on the effect on surrogates who made health care decisions for family members or friends looked at 40 studies that included empirical data on surrogates. Most surrogates were surveyed several months to years after making decisions, the majority of which were end-of-life decisions for family members or friends. At least one-third of surrogates experienced negative emotional burden as a result of making the decision. The most common effects were stress, guilt over the decisions they made, and doubt regarding whether they had made the right decisions.
Nine of the 40 studies also reported beneficial effects such as the support provided to the patient and the sense of satisfaction that the surrogate felt as a result of helping the patient. The most common factor cited in reduction of the negative effect on surrogates was knowing which treatment or choice was consistent with the patient's preferences.
1. Wendler D, Rid A. Systematic review: The effect on surrogates of making treatment decisions for others. Ann Intern Med 2011;154:336-346.
For more information about the effect of reimbursement cuts on hospice, contact:
Jonathan Keyserling, JD, Vice President of Public Policy, National Hospice and Palliative Care Organization, 1700 Diagonal Road, Suite 625, Alexandria, VA 22314. Telephone: (703) 837-1500. Fax: (703) 837-1233. E-mail: email@example.com.
Linda L. Rock, Executive Director, Prairie Haven Hospice, 2 West 42nd Street, Suite 2300 Scottsbluff, NE 69361. Telephone: (308) 630-1149. Fax: (308) 630-1886. E-mail: firstname.lastname@example.org.