老年人对延长生命治疗的偏好及其代理人的替代判断：老年人当前健康状况的影响。
Elders' preferences for life-prolonging treatment and their proxies' substituted judgment: influence of the elders' current health.
机构信息
Thomas Jefferson University, Philadelphia VA Medical Center, Philadelphia, PA 19104, USA.
出版信息
J Aging Health. 2012 Oct;24(7):1157-78. doi: 10.1177/0898264312454572. Epub 2012 Aug 6.
OBJECTIVE
People in poor health tend to view life-prolonging treatments (e.g., tube feeding) as more acceptable than do healthier people. Do proxies' substituted judgments reveal a similar tendency, showing greater acceptance when the elder is in worse health?
METHOD
In a cross-sectional telephone-based survey of 202 elderly individuals and their proxies, preferences for 4 life-prolonging treatments in 7 health prospects were examined in relation to the elder's current health status, operationalized as number of deficits in activities of daily living.
RESULTS
Stronger preferences for life-prolonging treatments in worse-health prospects were expressed by both elders and proxies when the elders' current health was relatively poor. The interaction effect was at least as pronounced for proxies' substituted judgment as for elders' own preferences.
DISCUSSION
Findings provide important insight into proxy decision making and have particular implications for proxy decision making on behalf of elders with dementia or other causes of decisional incapacity.
目的
身体状况不佳的人往往比健康状况良好的人更能接受延长生命的治疗（例如，鼻饲）。代理人的替代判断是否揭示了类似的倾向，即当老年人身体状况更差时，他们更倾向于接受治疗？
方法
在一项针对 202 名老年人及其代理人的横断面电话调查中，根据老年人目前的健康状况（即日常生活活动缺陷的数量），研究了 7 种健康前景下对 4 种延长生命的治疗方法的偏好。
结果
当老年人的健康状况相对较差时，老年人和代理人都对健康状况较差的前景下的延长生命治疗方法表现出更强的偏好。这种交互效应在代理人的替代判断中至少和老年人自己的偏好一样明显。
讨论
研究结果为代理决策提供了重要的见解，对代表痴呆或其他决策能力丧失的老年人进行代理决策具有特殊意义。
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