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Cited by 691Palliative Care and End-of-Life IssuesEthics in medical practiceEthics and bioethics in healthcare

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Systematic Review: The Effect on Surrogates of Making Treatment Decisions for Others

Wendler, David, Rid, Annette·2011·Annals of Internal Medicine
DOI 10.7326/0003-4819-154-5-201103010-00008
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Abstract

Background Clinical practice relies on surrogates to make or help to make treatment decisions for incapacitated adults; however, the effect of this practice on surrogates has not been evaluated. Purpose To assess the effect on surrogates of making treatment decisions for adults who cannot make their own decisions. Data sources Empirical studies published in English and listed in MEDLINE, EMBASE, CINAHL, BIOETHICSLINE, PsycINFO, or Scopus before 1 July 2010. Study selection Eligible studies provided quantitative or qualitative empirical data, by evaluating surrogates, regarding the effect on surrogates of making treatment decisions for an incapacitated adult. Data extraction Information on study location, number and type of surrogates, timing of data collection, type of decisions, patient setting, methods, main findings, and limitations. Data synthesis 40 studies, 29 using qualitative and 11 using quantitative methods, provided data on 2854 surrogates, more than one half of whom were family members of the patient. Most surrogates were surveyed several months to years after making treatment decisions, the majority of which were end-of-life decisions. The quantitative studies found that at least one third of surrogates experienced a negative emotional burden as the result of making treatment decisions. The qualitative studies reported that many or most surrogates experienced negative emotional burden. The negative effects on surrogates were often substantial and typically lasted…

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Metadata

Authors
Wendler, D., & Rid, A.
Affiliations
National Institutes of Health (US)
ORCID
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
2011-03-01
Volume
154
Issue
5
Pages
336-346
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/0003-4819-154-5-201103010-00008
OpenAlex
W2037404982
Cited by
691
References
1
Citations by year
2026: 46 · 2025: 46 · 2024: 34 · 2023: 42 · 2022: 37 · 2021: 56 · 2020: 64 · 2019: 52 · 2018: 54 · 2017: 47 · 2016: 41 · 2015: 38 · 2014: 40 · 2013: 38 · 2012: 40
FWCI
6.60
Type
journal article
Language
en
Open access
closed
Licence
www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
Keywords
surrogate decision-making, incapacitated adults, emotional burden, guilt, end-of-life decisions, family caregivers, patient preferences, decision regret, grief, prognostic uncertainty
MeSH terms
Anxiety, Decision Making, Family, Guilt, Humans, Stress, Psychological, Terminal Care, Advance Directives, Caregivers, Patient Preference

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