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Patients' preferences concerning medical information and surrogacy: results of a prospective study in a French emergency department.

Abstract：

OBJECTIVE:To study the wishes of a sample of French patients about medical information and surrogacy, at a time when the French Ministry of Health is supporting increased patient autonomy. DESIGN:A cohort of competent patients with non-critical illnesses or injuries completed an intention-to-act questionnaire on the amount of medical information they would want to receive should they be hospitalized or in a life-threatening situation. The percentage of patients who would want to have a surrogate if they were in a coma was determined, as well as the identity of the preferred surrogate. The subgroup of patients who were married or living with a partner was evaluated separately to determine how often the spouse/partner was the preferred surrogate. Associations were looked for between patients' wishes and age, sex, educational level, occupation, hierarchical order in the family, and level of confidence in medicine. SETTING:The emergency room of a teaching hospital in the Paris area (France). RESULTS:Of the 1089 patients included in the study, 5. 5 % reported that they would not want any information, 25.3 % that they would want to participate actively in all decisions about their care, and 87.3 % that they would want to be fully informed if they were in a life-threatening situation. Slightly less than one-third of the patients (29.6 %) believed they would not want a surrogate if they developed a coma. Among the patients living with a spouse/partner, 40.6 % (229/561) indicated they would want their spouse/partner to be their surrogate. A significant correlation was observed between wanting more information and wanting a surrogate. Younger patients with a higher educational level were significantly more likely to predict a desire for information and for a surrogate than the other patients. CONCLUSION:Our patients expressed a strong desire to receive extensive information should they become seriously ill, and two-thirds of them reported they would want a surrogate. However, only 40.6 % of the patients living with a spouse/partner would want their spouse/partner to be their surrogate. These data suggest that the time has probably come to propose a nation-wide public hearing on medical information and surrogacy in France.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Roupie E,Santin A,Boulme R,Wartel JS,Lepage E,Lemaire F,Lejonc JL,Montagne O

doi

10.1007/s001340050011

keywords:

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

52-6

issue

eissn

0342-4642

issn

1432-1238

pii

00260052.134

journal_volume

pub_type

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Patients' preferences concerning medical information and surrogacy: results of a prospective study in a French emergency department.