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Family optimism in ICU can impede end-of-life care decisions
Posted March 26, 2012
Relatives of patients in the intensive care unit respond to grim assessments of recovery with unwarranted optimism, says a study in Annals of Internal Medicine.
Researchers interviewed 80 surrogate decision-makers at three ICUs in San Francisco and offered hypothetical assessments about their loved one’s chances, such as, “He has a 5% chance of surviving.” The surrogates then noted their interpretation of the statement on a zero to 100% scale.
For good prognoses, family interpretations were on target, but when the odds of survival got worse so did the accuracy of surrogates’ interpretations, said the study, published March 6 (link).
Surrogates told researchers they had to hold on to hope and doubted the accuracy of the prognosis.
“Family members want to see the glass as half full, even if it’s really nearly empty,” said Douglas B. White, MD, the study’s lead author. He said such optimism can delay difficult discussions about moving away from aggressive interventions toward comfort care.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2012/03/26/prbf0326.htm.
