Patient age and decisions to withhold life-sustaining treatments from seriously ill, hospitalized adults

Annals of Internal Medicine

Volumn 130, Issue 2, 1999, Pages 116-125

  Hamel, Mary Beth ^a   Teno, Joan M ^b   Goldman, Lee ^c   Lynn, Joanne ^d   Davis, Roger B ^a   Galanos, Anthony N ^e   Desbiens, Norman ^f   Connors Jr , Alfred F ^g   Wenger, Neil ^h   Phillips, Russell S ^a  

^a BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

^b BROWN UNIVERSITY   (United States)

^c UNIVERSITY OF CALIFORNIA   (United States)

^d GEORGE WASHINGTON UNIVERSITY   (United States)

^e DUKE UNIVERSITY MEDICAL CENTER   (United States)

^f UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE   (United States)

^g UNIVERSITY OF VIRGINIA   (United States)

^h UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGE; AGED; ARTICLE; CONTROLLED STUDY; CRITICAL ILLNESS; DIALYSIS; FEMALE; HOSPITALIZATION; HUMAN; MAJOR CLINICAL STUDY; MALE; MEDICAL DECISION MAKING; PRIORITY JOURNAL; SURGERY; VENTILATOR;

EID: 0033582183     PISSN: 00034819     EISSN: None     Source Type: Journal    
DOI: 10.7326/0003-4819-130-2-199901190-00005     Document Type: Article

References (47)

1. Guidelines on the termination of life-sustaining treatment and the care of the dying a report by the Hastings Center Briarcliff Manor, NY The Hastings Center, 1987.
2. United States, President's Commission on the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research Deciding to forgo life-sustaining treatment: a report on the ethical, medical, and legal issues in treatment decisions President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research Washington, DC United States Government Printing Office; 1983.
3. Brennan TA. Ethics committees and decisions to limit care. The experience at the Massachusetts General Hospital JAMA 1988;260 803-7.
4. Hamel MB, Phillips RS, Teno JM, Lynn J, Galanos AN, Davis RB, et al. Seriously ill hospitalized adults do we spend less on older patients? SUPPORT Investigators Study to Understand Prognoses and Preference for Outcomes and Risks of Treatment J Am Geriatr Soc. 1996,44 1043-8
5. Tunis SR, Bass EB, Klag MJ, Steinberg EP. Variation in utilization of procedures for treatment of peripheral arterial disease A look at patient characteristics. Arch Intern Med. 1993,153:991-8
6. Callahan D. Setting Limits Medical Goals in an Aging Society New York: Simon & Schuster, 1987.
7. Callahan D. Must the old and young compete for health care resources? Neurosurgery. 1990;27:160-4
8. Callahan D. Adequate health care and an aging society, are they morally compatible? Daedalus 1986;(Winter) 247-67.
9. Veatch RM. Justice and the economics of terminal illness Hastings Cent Rep. 1988;18:34-40.
10. Daniels N. Is rationing by age ever morally acceptable? Bus Health. 1984,1: 29-32.
11. Cassel CK, Neugarten B. The goals of medicine in an aging society In. Binstock RH, Post SG, eds Too Old for Health Care? Controversies in Medcine, Law, Economics, and Ethics Baltimore Johns Hopkins Univ Pr, 1991.
12. Dougherty CJ. Ethical problems in healthcare rationing Testimony to the Senate Special Committee on Aging Health Prog 1991;72 32-9.
13. Jecker NS, Pearlman RA. Ethical constraints on rationing medical care by age J Am Geriatr Soc. 1989;37:1067-75
14. Evans JG. Aging and rationing [Editorial] BMJ 1991;303:869-70
15. Lynn J, Knaus WA. Background for SUPPORT J Clin Epidemiol 1990, 43(Suppl):1S-4S
16. A controlled trial to improve care for seriously ill hospitalized patients. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) The SUPPORT Principal Investigators JAMA 1995, 274:1541-8.
17. Knaus WA, Wagner DP, Draper EA, Zimmerman JE, Bergner M, Bastos PG, et al. The APACHE III prognostic system Risk predicton of hospital mortality for critically ill hospitalized adults. Chest 1991,100 1619-36.
18. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL a standardized measure of biological and psychosocial function. JAMA 1963;185 914-9.
19. Landefeld CS, Phillips RS, Bergner M. atient characteristics in SUPPORT functional status. J Clin Epidemiol 1990;43(Suppl) 37S-39S.
20. Hlatky MA, Boineau RE, Higginbotham MB, Lee KL, Mark DB, Califf RM, et al. A brief self-administered guestionnaire to determine functional capacity (the Duke Activity Status Index). Am J Cardiol. 1989;64:651-4
21. Phillips RS, Goldman L, Bergner M. Patient characteristics in SUPPORT: activity status and cognitive function. J Clin Epidemiol 1990,43(Suppl) 33S-36S
22. Stone CJ, Koo CY. Additive splines in statistics. Proceedings of the Statistical Computing Section of the American Statistical Assocation 1985;45-8
23. Knaus WA, Harrell FE Jr, Lynn J, Goldman L, Phillips RS, Connors AF Jr, et al. The SUPPORT prognostic model. Objective estimates of survival for seriously ill hospitalized adults Study To Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Ann Intern Med 1995,122:191-203.
24. Collett D. Modelling Survival Data in Medical Research. London: Chapman and Hall, 1994:95-100.
25. Allison PD. Survival Analysis Using the SAS System: A Practical Guide. Cary, NC: SAS Institute; 1995:165-73.
26. Yarzebski J, Goldberg RJ, Gore JM, Alpert JS. Temporal trends and factors associated with pulmonary artery catheterization in patients with acute myocardial infarction. Chest 1994,105:1003-8
27. Gurwitz JH, Osganian V, Goldberg RJ, Chen ZY, Gore JM, Alpert JS. Diagnostic testing in acute myocardial infarction does patient age influence utilization patterns? The Worcester Heart Attack Study. Am J Epidemiol. 1991,134:948-57
28. Bearden DM, Allman RM, Sundarum SV, Burst NM, Bartolucci AA. Age-related variability in the use of cardiovascular imaging procedures J Am Geriatr Soc. 1993;41 1075-82
29. Fleming C, D'Agostino RB, Selker HP. Is coronary-care-unit admission restricted for elderly patients? A multicenter study. Am J Public Health. 1991; 81:1121-6.
30. Naylor CD, Levinton CM, Baigrie RS, Goldman BS. Placing patients in the queue for coronary surgery do age and work status alter Canadian specialists' decisions? J Gen Intern Med. 1992;7:492-8
31. Greenfield S, Blanco DM, Elashoff RM, Ganz PA. Patterns of care related to age of breast cancer patients. JAMA. 1987,257:2766-70
32. Hakim RB, Teno JM, Harrell FE Jr, Knaus WA, Wenger N, Phillips RS, et al. Factors associated with do-not-resuscitate orders: patients' preferences, prognoses, and physicians' judgments SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment Ann Intern Med 1996;125:284-93
33. Lubitz JD, Riley GF. Trends in Medicare payments in the last year of life. N Engl J Med. 1993,328:1092-6
34. Lubitz J, Beebe J, Baker C. Longevity and Medicare expenditures. N Engl J Med. 1995,332:999-1003.
35. Butler RN. Age-ism. another form of bigotry. Gerontologist. 1969,9:243-6
36. Spence DL, Feigenbaum EM, Fitzgerald F, Roth J. Medical student attitudes toward the geriatric patient J Am Geriatr Soc. 1968,16:976-83
37. Geiger DL. Note how future professionals view the elderly a comparative analysis of social work, law, and medical students' perceptions Gerontologist. 1978,18:591-4.
38. Baker R. Visibility and the just allocation of health care a study of age-rationing in the British National Health Service. Health Care Anal 1993;1:139-50
39. Bowling A. Health care rationing: the public's debate. BMJ. 1996;312:670-4
40. Prottas J, Segal M, Sapolsky HM. Cross-national differences in dialysis rates. Health Care Financ Rev. 1983;4:91-103.
41. McKenzie JK, Moss AH, Feest TG, Stocking CB, Siegler M. Dialysis decision making in Canada, the United Kingdom, and the United States Am . Kidney Dis. 1998;31:12-8.
42. Murphy DJ, Burrows D, Santilli S, Kemp AW, Tenner S, Kreling B, et al. The influence of the probability of survival on patients' preferences regarding cardiopulmonary resuscitation N Engl J Med. 1994;330:545-9.
43. Wetle T. Age as a risk factor for inadequate treatment [Editorial]. JAMA 1987;258:516.
44. Wong JB, Salem DN, Pauker SG. You're never too old [Letter] N Eng J Med. 1993;328:971-5
45. Avorn J. Benefit and cost analysis in geriatric care. Turning age discrimination into health policy. N Engl J Med 1984;310:1294-301.
46. Phillips RS, Wenger NS, Teno J, Oye RK, Youngner S, Califf R, et al. Choices of seriously ill patients about cardiopulmonary resuscitation: correlates and outcomes. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments Am J Med 1995;100 128-37.
47. Frankl D, Oye RK, Bellamy PE. Attitudes of hospitalized patients toward life support: a survey of 200 medical inpatients. Am J Med 1989,86(6 Pt 1) 645-8