Related Experiment Videos
Physicians' experience with surrogate decision making for hospitalized adults
Alexia M Torke1, Mark Siegler, Anna Abalos
1Indiana University Center for Aging Research, Indianapolis, IN 46202, USA. atorke@iupui.edu
Journal of General Internal Medicine
|July 28, 2009
Summary
Physician-surrogate decision-making is common for hospitalized adults lacking capacity. Facilitating communication and advance care planning can improve agreement on treatment choices.
Area of Science:
- Medical Ethics
- Health Services Research
- Clinical Communication
Background:
- Hospitalized patients often lose decision-making capacity.
- Physician approaches to surrogate decision-making are not well understood.
Purpose of the Study:
- To describe physicians' experiences with surrogate communication and decision-making for hospitalized adults.
- To identify factors influencing physician-surrogate agreement.
Main Methods:
- Cross-sectional survey of 281 physicians across academic and community hospitals.
- Collected data on recent surrogate decision-making encounters, including decision nature, physician reaction, communication, and agreement.
Main Results:
- 73% of physicians made major decisions with surrogates in the past month.
- Physicians agreed with surrogates on medical facts (77%), prognosis (72%), and treatment (65%).
- Agreement was higher for older patients, ICU patients, and those who discussed wishes; lower when surrogates were hard to reach or physicians were Asian.
Conclusions:
- Surrogate decision-making is a frequent aspect of adult inpatient care.
- Enhancing physician-surrogate communication and promoting advance care planning can improve decision-making concordance.
Related Concept Videos
01:30Ethical Dilemmas II
Resolving an ethical dilemma in healthcare involves a systematic approach that considers every aspect of the issue, respecting both the patient's needs and values and the healthcare professional's ethical obligations. Here are potential steps to resolve an ethical dilemma:
01:30Psychosurgery
Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
01:27Ethical Issues
Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:
Ethical Concerns in Healthcare:
01:19Standards of Care II
Nurses bear specific legal responsibilities under several federal statutes, including:
01:27Nursing Ethical Principles II
Ethical principles are essential in guiding nurses to fulfill their responsibilities, focusing on the quality of nursing care and decision-making. These principles, including autonomy, beneficence, non-maleficence, justice, and fidelity, shape the ethical framework within healthcare settings.
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's cancer...
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's cancer...
01:13Patient-centered Care
Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...