Quality of Life and Recommendations for Further Care.
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OBJECTIVES: Physician recommendations for further medical treatment or palliative treatment only at the end of life may influence patient decisions. Little is known about the patient characteristics that affect physician-assessed quality of life or how such assessments are related to subsequent recommendations. DESIGN, SETTING, AND SUBJECTS: A 2010 mailed survey of practicing U.S. physicians (1,156/1,878 or 62% of eligible physicians responded). MEASUREMENTS AND MAIN RESULTS: Measures included an end of life vignette with five experimentally varied patient characteristics: setting, alimentation, pain, cognition, and communication. Physicians rated vignette patient quality of life on a scale from 0 to 100 and indicated whether they would recommend continuing full medical treatment or palliative treatment only. Cognitive deficits and alimentation had the greatest impacts on recommendations for further care, but pain and communication were also significant (all p < 0.001). Physicians who recommended continuing full medical treatment rated quality of life three times higher than those recommending palliative treatment only (40.41 vs 12.19; p < 0.01). Religious physicians were more likely to assess quality of life higher and to recommend full medical treatment. CONCLUSIONS: Physician judgments about quality of life are highly correlated with recommendations for further care. Patients and family members might consider these biases when negotiating medical decisions.
Attitude of Health Personnel
Continental Population Groups
Practice Patterns, Physicians'
Quality of Life
Religion and Medicine
Surveys and Questionnaires
Published Version (Please cite this version)10.1097/CCM.0000000000001846
Publication InfoPutman, MS; Tak, HJ; Curlin, Farr A; & Yoon, JD (2016). Quality of Life and Recommendations for Further Care. Crit Care Med, 44(11). pp. 1996-2002. 10.1097/CCM.0000000000001846. Retrieved from http://hdl.handle.net/10161/14619.
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Professor of Medicine
Farr A. Curlin, MD, is Josiah C. Trent Professor of Medical Humanities in the Trent Center for Bioethics, Humanities and History of Medicine, and Co-Director of the Theology, Medicine and Culture Initiative at Duke Divinity School. Before moving to Duke in 2014, he founded and was Co-Director of the Program on Medicine and Religion at the University of Chicago. At Duke, Farr practices palliative medicine and works with colleagues in the Trent Center an