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Proxy medical decision-making: national survey.

Andrew Ian-Hong Phua1,2, Camellia Zakaria3, Pavithren Vs Pakianathan4,5

  • 1National University Health System, Singapore drewphua@gmail.com.

BMJ Supportive & Palliative Care
|December 5, 2024
PubMed
Summary

Most adults in Singapore assist with medical decisions and daily living tasks for others. This informal caregiving, while common, can increase caregiver burden and risk of power abuse.

Keywords:
Advance Care PlanningAdvance DirectivesClinical decisionsEnd of life careFamily managementProxy

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Area of Science:

  • Gerontology
  • Public Health
  • Sociology

Background:

  • Population ageing and rising care needs necessitate adults making medical decisions for others.
  • Proxy medical decision-making significantly impacts patient treatment and end-of-life care.

Purpose of the Study:

  • To determine the prevalence of proxy medical decision-making in Singapore.
  • To identify demographic and care-related factors associated with this practice.

Main Methods:

  • A cross-sectional online survey was conducted.
  • A nationally representative sample of 311 Singapore residents participated.
  • An 80% participation rate was achieved.

Main Results:

  • 73% of respondents assisted with medical decisions, 58% with activities of daily living (ADLs), and 88% with instrumental ADLs (IADLs).
  • Digital caregiver accounts, lasting power of attorney, and assisting with ADLs/IADLs were linked to proxy decision-making.
  • No significant impact was observed for gender, ethnicity, income, or age.

Conclusions:

  • A majority of Singaporean adults engage in caregiving and proxy medical decision-making.
  • These informal helping behaviors may heighten caregiver burden and raise concerns about potential power abuse.