title: Elders' preferences for life-prolonging treatment and their proxies' substituted judgment: influence of the elders' current health.
abstract: 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?
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Thomas Jefferson University, Philadelphia VA Medical Center, Philadelphia, PA 19104, USA. laraine.winter@gmail.com
authors.forename: Laraine
authors.initials: L
authors.lastname: Winter
authors.forename: Susan M
authors.initials: SM
authors.lastname: Parks
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003625:Data Collection; D003657:Decision Making; D003704:Dementia; D005260:Female; D006304:Health Status; D006801:Humans; D007600:Judgment; D008020:Life Support Care; D008297:Male; D019727:Proxy; D020458:Third-Party Consent