Social and Behavioral Sciences Commons^™

Why Are They Wrong? Exploring Surrogates’ Accuracy When Predicting Patient Treatment Preferences, Rachael Lynn Spalding

Graduate Theses, Dissertations, and Problem Reports

Surrogate decision making is common in medical settings, particularly regarding treatment decisions for patients at end-of-life. When making decisions on behalf of patients, surrogates are most often encouraged to use the substituted judgment standard and make the decision that the patient would make if he or she were able to express a choice. A significant body of research, using patient-surrogate pairs and hypothetical vignettes, has documented that surrogates tend to inaccurately predict patient preferences when making these decisions (Shalowitz et al., 2006). This results in treatment decisions that do not match what the patient would have selected. Various factors that …