Stability of End-of-Life Preferences Original Investigation Research Invited Commentary Yael Schenker, MD, MAS; Douglas B. White, MD, MAS; Robert M. Arnold, MD The systematic review by Auriemma et al provides a valu- are more difficult to endure than she imagined, and the re- able synthesis of the evidence on stability of end-of-life (EOL) covery from anesthesia is slower. The clinical situation changes treatment preferences. Among 24 longitudinal studies in- (statistically, a second labor is likely to be quicker than the first), cluded in quantitative analysis, they found that in most (17 of influencing the probability that she will experience a particu- 24), more than 70% of patients’ preferences for EOL care were lar outcome. Full consideration of these factors results in a stable over periods ranging stable preference—not to receive an epidural—that is never- from weeks to years. The re- theless inaccurate when reappraised during active labor. This Related article page 1085 sults suggest a greater de- scenario illustrates the known difficulty with “affective fore- gree of preference stability among inpatients and seriously ill casting,” meaning that people often misjudge how they will outpatients than among older adults without serious illness respond to future health states. (although the former
JAMA Internal Medicine – American Medical Association
Published: Jul 1, 2014
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