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Family Decision Making in Foregoing Life-Extending Treatments

Oregon Health Sciences University, tildenv{at}ohsu.edu

Susan W. Tolle, M.D., F.A.C.P.

Oregon Health Sciences University

Christine A. Nelson, M.S., R.N.

Oregon Health Sciences University

Maye Thompson, Ph.D., R.N.

Oregon Health Sciences University

Susan C. Eggman, M.S.W.

Portland State University, Regional Research Institute

Families generally serve as surrogate decision makers for hospitalized dying patients who are unable to express their own decisions regarding life-prolonging treatments. The authors interviewed family members whose relatives died in the hospital following the withdrawal of aggressive medical treatments. Interviews were at two time periods: at 1 and 6 months post-patient death. Study data indicated a core set of phases which family members experienced in the process of arriving at the decision to withdraw treatment: recognition of futility, coming to terms, shouldering the surrogate role, and facing the question. At 6 months post decision, families reflected on the need for corroborating evidence that they had made the right decision, which the authors term seeking a triangulation of certainty. Advance directives and forthright communication from clinicians were two factors that most helped family members feel more positive about events.

Journal of Family Nursing, Vol. 5, No. 4, 426-442 (1999)
DOI: 10.1177/107484079900500405


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