Moorman Sara M, Hauser Robert M, Carr Deborah
Res Aging. 2009;31(4):463-491. doi: 10.1177/0164027509333683.
When terminally ill patients become mentally incapacitated, the patient's surrogate often makes treatment decisions in collaboration with health care providers. We examine how surrogates' errors in reporting their spouse's preferences are affected by their gender, status as durable power of attorney for health care (DPAHC), whether the surrogate and spouse held discussions about end-of-life preferences, and the spouse's health status. We apply structural equation models to data from 2,750 married couples in their mid 60s who participated in the 2004 wave of the Wisconsin Longitudinal Study. Surrogates reported their spouse's preferences incorrectly 13 and 26 percent of the time in end-of-life scenarios involving cognitive impairment and physical pain, respectively. Surrogates projected their own preferences onto the spouse. Similar patterns emerged regardless of surrogate gender, surrogate status as DPAHC, marital discussions about end-of-life, or spousal health status. We discuss implications for the process of surrogate decision-making and for future research.
当绝症患者出现精神上无行为能力的情况时，患者的代理人通常会与医疗服务提供者合作做出治疗决策。我们研究了代理人在报告其配偶的偏好时所犯的错误是如何受到其性别、作为医疗保健持久授权书（DPAHC）的身份、代理人与配偶是否就临终偏好进行过讨论以及配偶的健康状况影响的。我们将结构方程模型应用于来自2750对65岁左右已婚夫妇的数据，这些夫妇参与了2004年的威斯康星纵向研究。在涉及认知障碍和身体疼痛的临终场景中，代理人分别有13%和26%的时间错误地报告了其配偶的偏好。代理人将自己的偏好投射到了配偶身上。无论代理人的性别、作为DPAHC的身份、关于临终的婚姻讨论或配偶的健康状况如何，都出现了类似的模式。我们讨论了对代理人决策过程以及未来研究的影响。
