Life-sustaining treatment decisions: a social work response to meet needs of health care surrogates.

Surrogates must possess essential patient information prior to legitimately exercising legal and moral obligations to act on patients' medical care preferences. This descriptive, in vivo study examined factors influencing surrogate and proxy decisions (N = 132) following life-sustaining treatment decisions. Patient communication and self-efficacy variables accounted for approximately 38% of the variance in surrogates' perceptions of benefits/barriers associated with decision making. Guided by patients' advanced communication, respondents (97.8%) expressed high self-reliance and significant appreciation of benefits associated with their decisions. Clarifying surrogates' and providers' understanding of patient care preferences during ICU/CCU admission may facilitate better adherence to patient wishes.