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Keywords

end-of-life care, surrogate decision making

 

Authors

  1. Wilson, Debra MSN, FNP, CNL

Abstract

Advances in biomedical technology have blurred the lines between life and death. In the final days of life, the patient is often not able to verbalize his/her wishes regarding treatment decisions, leaving treatment decisions up to the family. Few studies have looked at the influences that affect the family decision-making process. The purpose of this study was to identify the factors that are important to families who must decide to either prolong or end treatment for patients who are seriously ill. A phenomenological research design was used to explore the experiences of the family members who had made end-of-life treatment decisions for a person close to them. Five themes were identified in this study on end-of-life decision making. These themes included knowing end-of-life wishes, communication with healthcare providers, acceptance/acknowledging futility, strengthening relationships with loved ones, and pain and symptom management. Knowing end-of-life wishes, communication with healthcare providers, acceptance/acknowledging futility, and strengthening relationships with loved ones influenced decisions made by surrogates. Pain and symptom management was expected regardless of the decision made by surrogates. However, surrogates were more likely to terminate aggressive treatment for patients in pain with little chance of recovery.