Focus Groups to Determine Surrogates Views Regarding Patient Preference Predictors

Current clinical practice relies on shared decision-making between clinicians and surrogates to make treatment decisions for patients who cannot decide on their own. This decision-making process is meant to promote medical care that accords with the patient s own preferences and values. However, empirical data suggest that this model faces two significant challenges. First, both surrogates and clinicians have trouble predicting which treatment course patients would have chosen. Second, given the nature of the decisions, surrogates often experience significant emotional distress as a result of making treatment decisions. To address these concerns it has been suggested that the shared decision-making process might be supplemented with a Patient Preference Predictor (PPP). A PPP would provide a prediction of which treatment a given patient would want based on the treatment preferences of similar patients in similar circumstances. The present study proposes to interview surrogates who have been involved in making decisions for an incapacitated patient to explore their perspectives on the PPP and how to incorporate it into medical decision-making for incapacitated patients..

• INCLUSION CRITERIA:
• 18 years or older
• Experience making at least one medical decision on behalf of an incompetent patient within the past 3 years. A medical decision for the purposes of this study is defined as making a decision in a context in which there was more than 1 feasible or reasonable option.
• Ability to provide informed consent

Exclusion criteria

• Inability to speak, understand, or read English
• The patient on behalf of whom the individual acted as surrogate is deceased for less than two months.
• In the view of the referring clinician, participation in the study is deemed excessively burdensome.
• Candidate for study is pregnant
• Court appointed surrogate