Healthcare decisions may take toll on proxies

Mon Feb 28, 2011 8:59pm EST
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NEW YORK (Reuters) - People who have to make treatment decisions for a seriously ill family member, including whether to continue or withdraw life support, may suffer emotional consequences as a result, according to a study.

At some point, nearly all critically ill people will become unable to make their own decisions about medical care. In those cases, the decisions fall to the next of kin by default, or to a healthcare "proxy" the patient has named in legal documents known as advance directives.

"We found a strong suggestion that it (making decisions) has a profound effect, and unfortunately it's often a negative one," said David Wendler of the U.S. National Institutes of Health, who led the research team.

For the study, published in the Annals of Internal Medicine, researchers reviewed 40 previous small studies on the emotional effects of such healthcare decisions.

In some studies, a small number of decision-makers -- most often a first-degree relative -- said the experience was positive, because they had been there to support their loved one.

But more often, family members felt anxiety, guilt or doubt about whether they had made the right choice.

Across all studies, at least one-third of decision-makers reported some type of emotional burden, in some cases months or even years after the fact.

But Wendler said none of that should discourage people from naming a healthcare proxy. In fact, family members were less likely to report negative emotional effects when they knew their loved one's preferences for end-of-life care.

"If anything, this should encourage more people to do" advance directives, he added.   Continued...