Spouse as health care proxy for dialysis patients: whose preferences matter?

Gerontologist. 2005 Dec;45(6):812-9. doi: 10.1093/geront/45.6.812.


Purpose: We examined the extent to which the substituted judgments made by spouses of patients with end-stage renal disease actually reflect patient preferences.

Design and methods: We used data from 291 couples to compare dialysis patients' preferences for continuing hemodialysis under a variety of hypothetical situations with both substituted judgment data from spouses and information about spouses' own preferences.

Results: Substituted judgments were more highly related to spouses' preferences than to patients' preferences.

Implications: Findings raise questions about the extent to which the moral principle of patient autonomy should guide decision making at the end of life.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Female
  • Humans
  • Interviews as Topic
  • Kidney Failure, Chronic
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Proxy*
  • Renal Dialysis*
  • Spouses*
  • Terminal Care