Dialysis patients' preferences for family-based advance care planning

Ann Intern Med. 1999 May 18;130(10):825-8. doi: 10.7326/0003-4819-130-10-199905180-00016.


Background: Most patients do not participate in advance care planning with physicians.

Objective: To examine patients' preferences for involving their physicians and families in advance care planning.

Design: Face-to-face interviews with randomly selected patients.

Setting: Community-based dialysis units in one rural and one urban region.

Participants: 400 hemodialysis patients.

Measurements: Questions about whom patients involve in advance care planning, whom patients would like to include in this planning, and patients' reactions to state legislation on surrogate decision makers in end-of-life care.

Results: Patients more frequently discussed preferences for end-of-life care with family members than with physicians (50% compared with 6%; P < 0.001). More patients wanted to include family members in future discussions of advance care planning than wanted to include physicians (91% compared with 36%; P < 0.001). Patients were most comfortable with legislation that granted their family end-of-life decision-making authority in the event of their own incapacity (P < 0.001).

Conclusion: Most patients want to include their families more than their physicians in advance care planning.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Advance Care Planning*
  • Advance Directives* / legislation & jurisprudence
  • Aged
  • Decision Making*
  • Family*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • New York
  • Patients / psychology*
  • Pennsylvania
  • Physician's Role
  • Physician-Patient Relations
  • Renal Dialysis*
  • Rural Population
  • Trust
  • United States
  • Urban Population
  • West Virginia