Actual and perceived stability of preferences for life-sustaining treatment

Journal of Clinical Ethics

Volumn 11, Issue 4, 2000, Pages 334-346

  Gready, R Mitchell ^a   Ditto, Peter H ^b   Danks, Joseph H ^c   Coppola, Kristen M ^d   Lockbart, Lisa K ^e   Smucker, William D ^f  

^a UNIVERSITY OF KENT   (United Kingdom)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c KENT STATE UNIVERSITY   (United States)

^d University in West Long Beach   (United States)

^e RADFORD UNIVERSITY   (United States)

^f SUMMA HEALTH SYSTEM   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AGE; AGED; ANALYSIS OF VARIANCE; ARTICLE; ATTITUDE TO HEALTH; DAILY LIFE ACTIVITY; DEATH AND EUTHANASIA; DECISION MAKING; EMPIRICAL APPROACH; FEMALE; FOLLOW UP; GERIATRIC ASSESSMENT; HEALTH STATUS; HUMAN; LIVING WILL; LONG TERM CARE; MALE; PROFESSIONAL PATIENT RELATIONSHIP; PSYCHOLOGICAL ASPECT; QUESTIONNAIRE; SOCIOECONOMICS; TIME; UNITED STATES;

DEATH AND EUTHANASIA; EMPIRICAL APPROACH; PROFESSIONAL PATIENT RELATIONSHIP;

ACTIVITIES OF DAILY LIVING; ADVANCE DIRECTIVES; AGE FACTORS; AGED; ANALYSIS OF VARIANCE; ATTITUDE TO HEALTH; CHOICE BEHAVIOR; FEMALE; FOLLOW-UP STUDIES; GERIATRIC ASSESSMENT; HEALTH STATUS; HUMANS; LIFE SUPPORT CARE; MALE; OHIO; QUESTIONNAIRES; SOCIOECONOMIC FACTORS; TIME FACTORS;

EID: 0034574431     PISSN: 10467890     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (20)

1. J.M. Teno, H.L. Nelson, and J. Lynn, "Advance Care Planning: Priorities for Ethical and Empirical Research," Hastings Center Report 24, no. 6 (November-December 1994): S32-S36; R.M. Veatch, "Ethical Dimensions of Advance Directives and Surrogate Decision Making in the United States," in Advance Directives and Surrogate Decision Making in Health Care: United States, Germany, and Japan, ed. H. Sass, R.M. Veatch, and R. Kimura (Baltimore, Md.: Johns Hopkins University Press, 1998), 66-91.
2. J.M. Teno, H.L. Nelson, and J. Lynn, "Advance Care Planning: Priorities for Ethical and Empirical Research," Hastings Center Report 24, no. 6 (November-December 1994): S32-S36; R.M. Veatch, "Ethical Dimensions of Advance Directives and Surrogate Decision Making in the United States," in Advance Directives and Surrogate Decision Making in Health Care: United States, Germany, and Japan, ed. H. Sass, R.M. Veatch, and R. Kimura (Baltimore, Md.: Johns Hopkins University Press, 1998), 66-91.
3. Linda Emanuel has argued that advance directives should not be taken as representing the individual's current wishes for treatment because incompetent individuals are, by definition "wishless." Even if one accepts this argument, the issue of stability is still important because one would want decisions to reflect the most recent version of an individual's prior wishes. Thus, Emanuel's argument changes the issue only slightly to concern not whether an advance directive completed years ago reflects an incapacitated individual's "current" wishes for treatment, but whether it represents the wishes he or she would have stated immediately prior to incapacitation. L. Emanuel, "Appropriate and Inappropriate Use of Advance Directives," The Journal of Clinical Ethics 5, no. 4 (1994): 357-9; L. Emanuel, "Advance Directives: Do They Work?" Journal of the American College of Cardiology 25 (1995): 35-8.
4. Linda Emanuel has argued that advance directives should not be taken as representing the individual's current wishes for treatment because incompetent individuals are, by definition "wishless." Even if one accepts this argument, the issue of stability is still important because one would want decisions to reflect the most recent version of an individual's prior wishes. Thus, Emanuel's argument changes the issue only slightly to concern not whether an advance directive completed years ago reflects an incapacitated individual's "current" wishes for treatment, but whether it represents the wishes he or she would have stated immediately prior to incapacitation. L. Emanuel, "Appropriate and Inappropriate Use of Advance Directives," The Journal of Clinical Ethics 5, no. 4 (1994): 357-9; L. Emanuel, "Advance Directives: Do They Work?" Journal of the American College of Cardiology 25 (1995): 35-8.
5. J.T. Berger and D. Majerovitz, "Stability of Preferences for Treatment Among Nursing Home Residents," Gerontologist 38, no. 2 (1998): 217-23; S. Carmel and E. Mutran, "Stability of Elderly Persons' Expressed Preferences Regarding the Use of Life-Sustaining Treatments," Social Science & Medicine 3 (1999):303-11; M.A. Everhart and R.A. Pearlman, "Stability of Patient Preferences Regarding Life-Sustaining Treatments," Chest 97, no. 1 (1990): 159-64; L.J. Schneiderman et al., "Relationship of General Advance Directive Instructions to Specific Life-Sustaining Treatment Preferences in Patients with Serious Illness," Archives of Internal Medicine 152, no. 10 (1992): 2114-22; L.L. Emanuel et al., "Advance Directives: Stability of Patients' Treatment Choices," Archives of Internal Medicine 154, no. 2 (1994): 209-17; K.E. Rosenfeld et al., "Factors Associated with Change in Resuscitation Preference of Seriously 111 Patients," Archives of Internal Medicine 156, no. 14 (1996): 1558-64; M. Danis et al., "Stability of Choices About Life-Sustaining Treatments," Annals of Internal Medicine 120, no. 7 (1994): 567-73; M.D. Silverstein et al., "Amyotrophic Lateral Sclerosis and Life-Sustaining Therapy: Patients' Desires for Information, Participation in Decision Making, and Life-Sustaining Therapy," Mayo Clinic Proceedings 66, no. 9 (1991): 906-13; N. Kohut et al., "Stability of Treatment Preferences: Although Most Preferences Do Not Change, Most People Change Some of Their Preferences," The Journal of Clinical Ethics 8, no. 2 (1997): 124-35; J.S. Weissman et al., "The Stability of Preferences for Life-Sustaining Care among Persons with AIDS in the Boston Health Study," Medical Decision Making 19 (1999): 16-26.
6. J.T. Berger and D. Majerovitz, "Stability of Preferences for Treatment Among Nursing Home Residents," Gerontologist 38, no. 2 (1998): 217-23; S. Carmel and E. Mutran, "Stability of Elderly Persons' Expressed Preferences Regarding the Use of Life-Sustaining Treatments," Social Science & Medicine 3 (1999):303-11; M.A. Everhart and R.A. Pearlman, "Stability of Patient Preferences Regarding Life-Sustaining Treatments," Chest 97, no. 1 (1990): 159-64; L.J. Schneiderman et al., "Relationship of General Advance Directive Instructions to Specific Life-Sustaining Treatment Preferences in Patients with Serious Illness," Archives of Internal Medicine 152, no. 10 (1992): 2114-22; L.L. Emanuel et al., "Advance Directives: Stability of Patients' Treatment Choices," Archives of Internal Medicine 154, no. 2 (1994): 209-17; K.E. Rosenfeld et al., "Factors Associated with Change in Resuscitation Preference of Seriously 111 Patients," Archives of Internal Medicine 156, no. 14 (1996): 1558-64; M. Danis et al., "Stability of Choices About Life-Sustaining Treatments," Annals of Internal Medicine 120, no. 7 (1994): 567-73; M.D. Silverstein et al., "Amyotrophic Lateral Sclerosis and Life-Sustaining Therapy: Patients' Desires for Information, Participation in Decision Making, and Life-Sustaining Therapy," Mayo Clinic Proceedings 66, no. 9 (1991): 906-13; N. Kohut et al., "Stability of Treatment Preferences: Although Most Preferences Do Not Change, Most People Change Some of Their Preferences," The Journal of Clinical Ethics 8, no. 2 (1997): 124-35; J.S. Weissman et al., "The Stability of Preferences for Life-Sustaining Care among Persons with AIDS in the Boston Health Study," Medical Decision Making 19 (1999): 16-26.
7. J.T. Berger and D. Majerovitz, "Stability of Preferences for Treatment Among Nursing Home Residents," Gerontologist 38, no. 2 (1998): 217-23; S. Carmel and E. Mutran, "Stability of Elderly Persons' Expressed Preferences Regarding the Use of Life-Sustaining Treatments," Social Science & Medicine 3 (1999):303-11; M.A. Everhart and R.A. Pearlman, "Stability of Patient Preferences Regarding Life-Sustaining Treatments," Chest 97, no. 1 (1990): 159-64; L.J. Schneiderman et al., "Relationship of General Advance Directive Instructions to Specific Life-Sustaining Treatment Preferences in Patients with Serious Illness," Archives of Internal Medicine 152, no. 10 (1992): 2114-22; L.L. Emanuel et al., "Advance Directives: Stability of Patients' Treatment Choices," Archives of Internal Medicine 154, no. 2 (1994): 209-17; K.E. Rosenfeld et al., "Factors Associated with Change in Resuscitation Preference of Seriously 111 Patients," Archives of Internal Medicine 156, no. 14 (1996): 1558-64; M. Danis et al., "Stability of Choices About Life-Sustaining Treatments," Annals of Internal Medicine 120, no. 7 (1994): 567-73; M.D. Silverstein et al., "Amyotrophic Lateral Sclerosis and Life-Sustaining Therapy: Patients' Desires for Information, Participation in Decision Making, and Life-Sustaining Therapy," Mayo Clinic Proceedings 66, no. 9 (1991): 906-13; N. Kohut et al., "Stability of Treatment Preferences: Although Most Preferences Do Not Change, Most People Change Some of Their Preferences," The Journal of Clinical Ethics 8, no. 2 (1997): 124-35; J.S. Weissman et al., "The Stability of Preferences for Life-Sustaining Care among Persons with AIDS in the Boston Health Study," Medical Decision Making 19 (1999): 16-26.
8. J.T. Berger and D. Majerovitz, "Stability of Preferences for Treatment Among Nursing Home Residents," Gerontologist 38, no. 2 (1998): 217-23; S. Carmel and E. Mutran, "Stability of Elderly Persons' Expressed Preferences Regarding the Use of Life-Sustaining Treatments," Social Science & Medicine 3 (1999):303-11; M.A. Everhart and R.A. Pearlman, "Stability of Patient Preferences Regarding Life-Sustaining Treatments," Chest 97, no. 1 (1990): 159-64; L.J. Schneiderman et al., "Relationship of General Advance Directive Instructions to Specific Life-Sustaining Treatment Preferences in Patients with Serious Illness," Archives of Internal Medicine 152, no. 10 (1992): 2114-22; L.L. Emanuel et al., "Advance Directives: Stability of Patients' Treatment Choices," Archives of Internal Medicine 154, no. 2 (1994): 209-17; K.E. Rosenfeld et al., "Factors Associated with Change in Resuscitation Preference of Seriously 111 Patients," Archives of Internal Medicine 156, no. 14 (1996): 1558-64; M. Danis et al., "Stability of Choices About Life-Sustaining Treatments," Annals of Internal Medicine 120, no. 7 (1994): 567-73; M.D. Silverstein et al., "Amyotrophic Lateral Sclerosis and Life-Sustaining Therapy: Patients' Desires for Information, Participation in Decision Making, and Life-Sustaining Therapy," Mayo Clinic Proceedings 66, no. 9 (1991): 906-13; N. Kohut et al., "Stability of Treatment Preferences: Although Most Preferences Do Not Change, Most People Change Some of Their Preferences," The Journal of Clinical Ethics 8, no. 2 (1997): 124-35; J.S. Weissman et al., "The Stability of Preferences for Life-Sustaining Care among Persons with AIDS in the Boston Health Study," Medical Decision Making 19 (1999): 16-26.
9. J.T. Berger and D. Majerovitz, "Stability of Preferences for Treatment Among Nursing Home Residents," Gerontologist 38, no. 2 (1998): 217-23; S. Carmel and E. Mutran, "Stability of Elderly Persons' Expressed Preferences Regarding the Use of Life-Sustaining Treatments," Social Science & Medicine 3 (1999):303-11; M.A. Everhart and R.A. Pearlman, "Stability of Patient Preferences Regarding Life-Sustaining Treatments," Chest 97, no. 1 (1990): 159-64; L.J. Schneiderman et al., "Relationship of General Advance Directive Instructions to Specific Life-Sustaining Treatment Preferences in Patients with Serious Illness," Archives of Internal Medicine 152, no. 10 (1992): 2114-22; L.L. Emanuel et al., "Advance Directives: Stability of Patients' Treatment Choices," Archives of Internal Medicine 154, no. 2 (1994): 209-17; K.E. Rosenfeld et al., "Factors Associated with Change in Resuscitation Preference of Seriously 111 Patients," Archives of Internal Medicine 156, no. 14 (1996): 1558-64; M. Danis et al., "Stability of Choices About Life-Sustaining Treatments," Annals of Internal Medicine 120, no. 7 (1994): 567-73; M.D. Silverstein et al., "Amyotrophic Lateral Sclerosis and Life-Sustaining Therapy: Patients' Desires for Information, Participation in Decision Making, and Life-Sustaining Therapy," Mayo Clinic Proceedings 66, no. 9 (1991): 906-13; N. Kohut et al., "Stability of Treatment Preferences: Although Most Preferences Do Not Change, Most People Change Some of Their Preferences," The Journal of Clinical Ethics 8, no. 2 (1997): 124-35; J.S. Weissman et al., "The Stability of Preferences for Life-Sustaining Care among Persons with AIDS in the Boston Health Study," Medical Decision Making 19 (1999): 16-26.
10. J.T. Berger and D. Majerovitz, "Stability of Preferences for Treatment Among Nursing Home Residents," Gerontologist 38, no. 2 (1998): 217-23; S. Carmel and E. Mutran, "Stability of Elderly Persons' Expressed Preferences Regarding the Use of Life-Sustaining Treatments," Social Science & Medicine 3 (1999):303-11; M.A. Everhart and R.A. Pearlman, "Stability of Patient Preferences Regarding Life-Sustaining Treatments," Chest 97, no. 1 (1990): 159-64; L.J. Schneiderman et al., "Relationship of General Advance Directive Instructions to Specific Life-Sustaining Treatment Preferences in Patients with Serious Illness," Archives of Internal Medicine 152, no. 10 (1992): 2114-22; L.L. Emanuel et al., "Advance Directives: Stability of Patients' Treatment Choices," Archives of Internal Medicine 154, no. 2 (1994): 209-17; K.E. Rosenfeld et al., "Factors Associated with Change in Resuscitation Preference of Seriously 111 Patients," Archives of Internal Medicine 156, no. 14 (1996): 1558-64; M. Danis et al., "Stability of Choices About Life-Sustaining Treatments," Annals of Internal Medicine 120, no. 7 (1994): 567-73; M.D. Silverstein et al., "Amyotrophic Lateral Sclerosis and Life-Sustaining Therapy: Patients' Desires for Information, Participation in Decision Making, and Life-Sustaining Therapy," Mayo Clinic Proceedings 66, no. 9 (1991): 906-13; N. Kohut et al., "Stability of Treatment Preferences: Although Most Preferences Do Not Change, Most People Change Some of Their Preferences," The Journal of Clinical Ethics 8, no. 2 (1997): 124-35; J.S. Weissman et al., "The Stability of Preferences for Life-Sustaining Care among Persons with AIDS in the Boston Health Study," Medical Decision Making 19 (1999): 16-26.
11. J.T. Berger and D. Majerovitz, "Stability of Preferences for Treatment Among Nursing Home Residents," Gerontologist 38, no. 2 (1998): 217-23; S. Carmel and E. Mutran, "Stability of Elderly Persons' Expressed Preferences Regarding the Use of Life-Sustaining Treatments," Social Science & Medicine 3 (1999):303-11; M.A. Everhart and R.A. Pearlman, "Stability of Patient Preferences Regarding Life-Sustaining Treatments," Chest 97, no. 1 (1990): 159-64; L.J. Schneiderman et al., "Relationship of General Advance Directive Instructions to Specific Life-Sustaining Treatment Preferences in Patients with Serious Illness," Archives of Internal Medicine 152, no. 10 (1992): 2114-22; L.L. Emanuel et al., "Advance Directives: Stability of Patients' Treatment Choices," Archives of Internal Medicine 154, no. 2 (1994): 209-17; K.E. Rosenfeld et al., "Factors Associated with Change in Resuscitation Preference of Seriously 111 Patients," Archives of Internal Medicine 156, no. 14 (1996): 1558-64; M. Danis et al., "Stability of Choices About Life-Sustaining Treatments," Annals of Internal Medicine 120, no. 7 (1994): 567-73; M.D. Silverstein et al., "Amyotrophic Lateral Sclerosis and Life-Sustaining Therapy: Patients' Desires for Information, Participation in Decision Making, and Life-Sustaining Therapy," Mayo Clinic Proceedings 66, no. 9 (1991): 906-13; N. Kohut et al., "Stability of Treatment Preferences: Although Most Preferences Do Not Change, Most People Change Some of Their Preferences," The Journal of Clinical Ethics 8, no. 2 (1997): 124-35; J.S. Weissman et al., "The Stability of Preferences for Life-Sustaining Care among Persons with AIDS in the Boston Health Study," Medical Decision Making 19 (1999): 16-26.
12. J.T. Berger and D. Majerovitz, "Stability of Preferences for Treatment Among Nursing Home Residents," Gerontologist 38, no. 2 (1998): 217-23; S. Carmel and E. Mutran, "Stability of Elderly Persons' Expressed Preferences Regarding the Use of Life-Sustaining Treatments," Social Science & Medicine 3 (1999):303-11; M.A. Everhart and R.A. Pearlman, "Stability of Patient Preferences Regarding Life-Sustaining Treatments," Chest 97, no. 1 (1990): 159-64; L.J. Schneiderman et al., "Relationship of General Advance Directive Instructions to Specific Life-Sustaining Treatment Preferences in Patients with Serious Illness," Archives of Internal Medicine 152, no. 10 (1992): 2114-22; L.L. Emanuel et al., "Advance Directives: Stability of Patients' Treatment Choices," Archives of Internal Medicine 154, no. 2 (1994): 209-17; K.E. Rosenfeld et al., "Factors Associated with Change in Resuscitation Preference of Seriously 111 Patients," Archives of Internal Medicine 156, no. 14 (1996): 1558-64; M. Danis et al., "Stability of Choices About Life-Sustaining Treatments," Annals of Internal Medicine 120, no. 7 (1994): 567-73; M.D. Silverstein et al., "Amyotrophic Lateral Sclerosis and Life-Sustaining Therapy: Patients' Desires for Information, Participation in Decision Making, and Life-Sustaining Therapy," Mayo Clinic Proceedings 66, no. 9 (1991): 906-13; N. Kohut et al., "Stability of Treatment Preferences: Although Most Preferences Do Not Change, Most People Change Some of Their Preferences," The Journal of Clinical Ethics 8, no. 2 (1997): 124-35; J.S. Weissman et al., "The Stability of Preferences for Life-Sustaining Care among Persons with AIDS in the Boston Health Study," Medical Decision Making 19 (1999): 16-26.
13. J.T. Berger and D. Majerovitz, "Stability of Preferences for Treatment Among Nursing Home Residents," Gerontologist 38, no. 2 (1998): 217-23; S. Carmel and E. Mutran, "Stability of Elderly Persons' Expressed Preferences Regarding the Use of Life-Sustaining Treatments," Social Science & Medicine 3 (1999):303-11; M.A. Everhart and R.A. Pearlman, "Stability of Patient Preferences Regarding Life-Sustaining Treatments," Chest 97, no. 1 (1990): 159-64; L.J. Schneiderman et al., "Relationship of General Advance Directive Instructions to Specific Life-Sustaining Treatment Preferences in Patients with Serious Illness," Archives of Internal Medicine 152, no. 10 (1992): 2114-22; L.L. Emanuel et al., "Advance Directives: Stability of Patients' Treatment Choices," Archives of Internal Medicine 154, no. 2 (1994): 209-17; K.E. Rosenfeld et al., "Factors Associated with Change in Resuscitation Preference of Seriously 111 Patients," Archives of Internal Medicine 156, no. 14 (1996): 1558-64; M. Danis et al., "Stability of Choices About Life-Sustaining Treatments," Annals of Internal Medicine 120, no. 7 (1994): 567-73; M.D. Silverstein et al., "Amyotrophic Lateral Sclerosis and Life-Sustaining Therapy: Patients' Desires for Information, Participation in Decision Making, and Life-Sustaining Therapy," Mayo Clinic Proceedings 66, no. 9 (1991): 906-13; N. Kohut et al., "Stability of Treatment Preferences: Although Most Preferences Do Not Change, Most People Change Some of Their Preferences," The Journal of Clinical Ethics 8, no. 2 (1997): 124-35; J.S. Weissman et al., "The Stability of Preferences for Life-Sustaining Care among Persons with AIDS in the Boston Health Study," Medical Decision Making 19 (1999): 16-26.
14. J.T. Berger and D. Majerovitz, "Stability of Preferences for Treatment Among Nursing Home Residents," Gerontologist 38, no. 2 (1998): 217-23; S. Carmel and E. Mutran, "Stability of Elderly Persons' Expressed Preferences Regarding the Use of Life-Sustaining Treatments," Social Science & Medicine 3 (1999):303-11; M.A. Everhart and R.A. Pearlman, "Stability of Patient Preferences Regarding Life-Sustaining Treatments," Chest 97, no. 1 (1990): 159-64; L.J. Schneiderman et al., "Relationship of General Advance Directive Instructions to Specific Life-Sustaining Treatment Preferences in Patients with Serious Illness," Archives of Internal Medicine 152, no. 10 (1992): 2114-22; L.L. Emanuel et al., "Advance Directives: Stability of Patients' Treatment Choices," Archives of Internal Medicine 154, no. 2 (1994): 209-17; K.E. Rosenfeld et al., "Factors Associated with Change in Resuscitation Preference of Seriously 111 Patients," Archives of Internal Medicine 156, no. 14 (1996): 1558-64; M. Danis et al., "Stability of Choices About Life-Sustaining Treatments," Annals of Internal Medicine 120, no. 7 (1994): 567-73; M.D. Silverstein et al., "Amyotrophic Lateral Sclerosis and Life-Sustaining Therapy: Patients' Desires for Information, Participation in Decision Making, and Life-Sustaining Therapy," Mayo Clinic Proceedings 66, no. 9 (1991): 906-13; N. Kohut et al., "Stability of Treatment Preferences: Although Most Preferences Do Not Change, Most People Change Some of Their Preferences," The Journal of Clinical Ethics 8, no. 2 (1997): 124-35; J.S. Weissman et al., "The Stability of Preferences for Life-Sustaining Care among Persons with AIDS in the Boston Health Study," Medical Decision Making 19 (1999): 16-26.
15. Berger and Majerovitz; Carmel and Mutran; Emanuel et al.; Everhart and Pearlman; Schneiderman et al.; Rosenfeld et al.; see note 3 above.
16. Danis et al.; Kohut et al.; Silverstein et al.; Weissman et al.; see note 3 above.
17. M. Ross, "Relation of Implicit Theories to the Construction of Personal Histories," Psychological Review 96 (1989): 341-57; G.R. Goethals and R.F. Reckman, "The Perception of Consistency in Attitudes," Journal of Experimental Social Psychology 9 (1973): 491-501; G.B. Markus, "Stability and Change in Political Attitudes: Observed, Recalled, and Explained," Political Behavior 8, no. 1 (1986): 21-44.
18. M. Ross, "Relation of Implicit Theories to the Construction of Personal Histories," Psychological Review 96 (1989): 341-57; G.R. Goethals and R.F. Reckman, "The Perception of Consistency in Attitudes," Journal of Experimental Social Psychology 9 (1973): 491-501; G.B. Markus, "Stability and Change in Political Attitudes: Observed, Recalled, and Explained," Political Behavior 8, no. 1 (1986): 21-44.
19. M. Ross, "Relation of Implicit Theories to the Construction of Personal Histories," Psychological Review 96 (1989): 341-57; G.R. Goethals and R.F. Reckman, "The Perception of Consistency in Attitudes," Journal of Experimental Social Psychology 9 (1973): 491-501; G.B. Markus, "Stability and Change in Political Attitudes: Observed, Recalled, and Explained," Political Behavior 8, no. 1 (1986): 21-44.
20. G.B. Markus, see note 6 above.