The basic of this study examines discordance in preference for life-extending care versus comfort-focused care and its association with do-not-resuscitate (DNR) order placement.
One hundred eighty-nine patients with advanced cancers refractory to at least one chemotherapy regimen were enrolled in a multisite observational study. In structured interviews, patients reported their preference for treatment maximizing either life extension or comfort; patients also indicated their perception of their families’ preference.
Participants on average were approximately age 60 years and had some college education. The majority were women (61%), married (58.4%), insured (71.7%), white (84.1%), and non-Latino (86.7%).We found that 7.9% of patients preferred comfort-focused care but perceived their families to hold a discordant preference for life-extending care; 14.8% showed an opposite pattern where they preferred life-extending care but perceived their families to hold a discordant preference for comfort-focused care. In contrast, 32.8% of patients showed concordance between themselves and their families in preferring comfort-focused care, whereas 44.4% showed concordance preferring life-extending care.A total of 22.7% of patients (n = 43) perceived discordance between what they wanted and what their families wanted for care. Patients who perceived discordance did not differ from those who perceived concordance on demographics or other patient characteristics
A lot of people have discordance between personal and family treatment preferences and these data are enough to prove this.
https://ascopubs.org/doi/full/10.1200/JOP.19.00250
