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Updated: May 12, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Patient-physician communication about code status preferences: a randomized controlled trial.

Wadih Rhondali¹, Pedro Perez-Cruz, David Hui

¹Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

|April 9, 2013

Summary

This summary is machine-generated.

Physicians ending code status discussions with a question or recommendation did not affect do-not-resuscitate (DNR) preferences. Both approaches are appropriate, with age and race influencing patient decisions.

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Published on: January 8, 2020

Area of Science:

Oncology
Palliative Care
Medical Ethics

Background:

Code status discussions are crucial in cancer care.
Optimal communication strategies for these discussions remain unclear.
This study investigated physician communication approaches in code status discussions.

Purpose of the Study:

To determine if ending code status discussions with a question (autonomy) versus a recommendation (beneficence) impacts patient do-not-resuscitate (DNR) preferences.
To assess the influence of these approaches on perceived physician compassion.

Main Methods:

Patients viewed two videos of physician-patient code status discussions, differing only in the ending (question vs. recommendation).
Participants were randomized to video sequences.
The primary outcome was the proportion of patients choosing DNR for the video patient.

Main Results:

74% chose DNR after the question video; 73% chose DNR after the recommendation video.
Physician compassion scores were high and similar for both approaches.
Patient's own DNR choice, age, and race predicted their decision for the video patient.

Conclusions:

The communication approach (question vs. recommendation) did not significantly alter DNR preferences or physician compassion perception.
Both autonomy and beneficence approaches are clinically appropriate for code status discussions.
Patient's prior DNR decisions, age, and race are significant predictors of DNR choice.