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Comfort vs. Longevity: Who Decides?
More than a third of seriously ill patients who requested
that doctors ease their discomfort instead of prolonging
their lives appear to have had their wishes overlooked, a
new study reports.
The findings were based on a study of 1,185 Medicare patients
at five teaching hospitals across the country who were
suffering illnesses like multiple organ failure, cancer
and congestive heart failure.
The researchers, who report their findings in the current
Journal of the American Geriatrics Society, were unable to
review the patients' medical files directly. Instead, they
asked the patients whether they had expressed a treatment
preference and whether the hospital appeared to be following
their wishes.
But evidence supported the patients' belief that doctors were
trying to prolong their lives, despite their wishes, said the
lead author of the study, Dr. Joan M. Teno of Brown University.
The patients had higher medical bills and lived longer than
comparable patients who thought their wishes were being respected.
About 60 percent of patients said they wanted doctors to focus
on making them comfortable. "Our findings suggest that physicians
are unaware of their patients' preferences or, worse, that they
are actively ignoring them," the authors wrote.
[03/12/2002; New York Times
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