Family optimism in ICU can impede end-of-life care decisions

Posted March 26, 2012

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

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

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn