Patients Often Unreliable Predictors of Their Own End-of-Life Treatment Preferences

First, we're told that a third of the time family members can't predict the end-of-life treatment preferences of their loved ones [abstract; pdf (requires subscription)].  Then, we learn that physicians typically misjudge the end-of-life treatment preferences of elderly patients (see, e.g., Journal of Family Practice, Nov 1993 v37 n5 p469(7)).  Now, here comes an article in this week's Archives of Internal Medicine [subscription required; abstract] that tells us patients themselves, at least 20 percent of the time, misjudge their actual treatment preferences at the end of life. The policy preference these articles seem to point toward is increased use of designated surrogate decision makers (i.e., through medical powers of attorney) and decreased reliance on living wills, which are typically executed before a patient has received a terminal diagnosis. [tm]