Surrogate Decision Making

该司以前的工作表明，代理人在各种情况下对患者应该接受哪些治疗的选择往往与患者自己的治疗偏好不一致(Shalowitz，2006)。社会心理学的研究表明，代孕不准确只是更普遍地无法预测所爱之人的偏好和价值观的一个例子。这项研究发现，在亲密的关系中，我们都会受到心理偏见的影响，这些偏见很难纠正。这些偏见表明，代孕药准确性的改善是不可能的，这一结论得到了我们的数据的支持，数据显示，两种讨论最广泛的改进方法--任命代孕者，以及与此人讨论个人的治疗偏好和价值观--通常是无效的。为了评估患者希望如何为他们做出决定，一旦他们认识到代孕不准确的程度，该部门开发并进行了一项关于患者对代孕决策偏好的最大调查之一。这项调查在乔治华盛顿医院和诊所招募了1180名患者，最近完成了调查，并开始了数据分析。这项调查还旨在评估患者对使用患者偏好预测指标的态度。数据分析正在进行中。

Previous work by the Department revealed that surrogates' choices of which treatments patients should receive in a range of circumstances are often inconsistent with the patients own treatment preferences (Shalowitz 2006). Research in social psychology suggests that surrogate inaccuracy is just one example of a more general inability to predict the preferences and values of loved ones. This research finds that we all are subject to psychological biases in close relationships that are extremely difficult to correct. These biases suggest that improvements in surrogate accuracy are unlikely, a conclusion which is supported by our data showing that the two most widely-discussed methods for improvement appointing a surrogate, and discussing ones treatment preferences and values with this person are generally ineffective. To evaluate how patients want to have decisions made for them, once they recognize the extent of surrogate inaccuracy, the Department developed and conducted one of the largest surveys on patients preferences regarding surrogate decision making. This survey, which enrolled 1180 patients at George Washington Hospital and Clinics, was recently completed and data analysis has begun. This survey also was designed to evaluate patient attitudes toward using a patient preference predictor. Data analysis is in progress.