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Spouse as health care proxy for dialysis patients: whose preferences matter?
Rachel A Pruchno1, Edward P Lemay, Lucy Feild
1Intiatives on Aging, Boston College, MA, USA. pruchnra@umdnj.edu
Purpose:
We examined the extent to which the substituted judgments made by spouses of patients with end-stage renal disease actually reflect patient preferences.
Design And Methods:
We used data from 291 couples to compare dialysis patients' preferences for continuing hemodialysis under a variety of hypothetical situations with both substituted judgment data from spouses and information about spouses' own preferences.
Results:
Substituted judgments were more highly related to spouses' preferences than to patients' preferences.
Implications:
Findings raise questions about the extent to which the moral principle of patient autonomy should guide decision making at the end of life.
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