This Article Full Text Full Text (PDF) Services Download to citation manager Citing Articles Citing Articles via HighWire PubMed PubMed Citation

Spouse as Health Care Proxy for Dialysis Patients: Whose Preferences Matter?

Correspondence: Address correspondence to Rachel A. Pruchno, PhD, Director of Research, Center for Aging, University of Medicine & Dentistry of New Jersey, School of Osteopathic Medicine, 42 E. Laurel Rd., Suite 2300, Stratford, NJ 08084. E-mail: pruchnra{at}umdnj.edu

Purpose: We examined the extent to which the substituted judgments made by spouses of patients with end-stage renal disease actually reflect patient preferences. Design and Methods: We used data from 291 couples to compare dialysis patients' preferences for continuing hemodialysis under a variety of hypothetical situations with both substituted judgment data from spouses and information about spouses' own preferences. Results: Substituted judgments were more highly related to spouses' preferences than to patients' preferences. Implications: Findings raise questions about the extent to which the moral principle of patient autonomy should guide decision making at the end of life.

Key Words: End of life • Autonomy • Decision making • End-stage renal disease • Substituted judgments • Proxy

This article has been cited by other articles:

				R. A. Pruchno, M. J. Rovine, F. Cartwright, and M. Wilson-Genderson Stability and Change in Patient Preferences and Spouse Substituted Judgments Regarding Dialysis Continuation J. Gerontol. B. Psychol. Sci. Soc. Sci., March 1, 2008; 63(2): S81 - S91. [Abstract] [Full Text] [PDF]