Treatment preferences: impact of risk and benefit in decision-making.
Understanding treatment preferences of seriously ill patients is complex. Previous studies have shown a correlation between the burden and outcome of a treatment and the likelihood a patient will accept a given intervention. In this study the Willingness to Accept Life Sustaining Treatment (WALT) survey was used in a predominantly Latino population receiving care at a large urban safety net hospital. Eligible patients were cared for by one of four clinics: (1) human immunodeficiency virus (HIV); (2) geriatrics; (3) oncology; or (4) cardiology. Hypothetical scenarios reflecting outcomes of resuscitation were presented and patients were given information on the burden and outcome of treatment. They were then given the option of accepting or declining treatment; 237 completed the survey. Patients in our study were willing to accept a high level of cognitive (vegetative state) and functional (bed-bound) impairment even when the chance of recovery was exceedingly low.
Stone
Susan C
SC
Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA. sstone_90064@yahoo.com
Mohanty
Sarita A
SA
McClung
Christian D
CD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D003657:Decision Making; D004502:Education, Medical, Continuing; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010342:Patient Acceptance of Health Care; D057240:Patient Preference; D018570:Risk Assessment; D013727:Terminal Care; D055815:Young Adult