title: Spouse as health care proxy for dialysis patients: whose preferences matter?
abstract: OBJECTIVE
  We examined the extent to which the substituted judgments made by spouses of patients with end-stage renal disease actually reflect patient preferences.
  
  
  METHODS
  We used data from 291 couples to compare dialysis patients' preferences for continuing hemodialysis under a variety of hypothetical situations with both substituted judgment data from spouses and information about spouses' own preferences.
  
  
  RESULTS
  Substituted judgments were more highly related to spouses' preferences than to patients' preferences.
  
  
  CONCLUSIONS
  Findings raise questions about the extent to which the moral principle of patient autonomy should guide decision making at the end of life.
authors.affiliation: Intiatives on Aging, Boston College, MA, USA. pruchnra@umdnj.edu
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Pruchno
authors.forename: Edward P
authors.initials: EP
authors.lastname: Lemay
authors.forename: Lucy
authors.initials: L
authors.lastname: Feild
authors.forename: Norman G
authors.initials: NG
authors.lastname: Levinsky
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007676:Kidney Failure, Chronic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019727:Proxy; D006435:Renal Dialysis; D018454:Spouses; D013727:Terminal Care