Factors Affecting Life-Sustaining Treatment Decisions by Health Care Surrogates and Proxies: Assessing Benefits and Barriers

Abstract

Terri Schiavo's life and death placed international focus on social workers' need to better understand and serve health care surrogates and proxies making life-sustaining treatment decisions on behalf of medical patients. This study (N = 132) reports initial validation of a new measure, the Acceptance of Treatment Choice Inventory (ATCI), designed to evaluate benefits and barriers considered by health care surrogates and proxies prior to making a life-sustaining treatment decision about CPR, tube-feedings, dialysis, and ventilation. Affirming a two-factor model with acceptable reliability and preliminary construct validity, surrogates sought decision support and desired to represent patients' wishes adequately.

KEYWORDS:

• health care surrogate
• health care proxy
• life-sustaining treatment decisions
• health care decision-making
• HBM (Health Belief Model)

Notes

Patient Self-Determination Act (PSDA) of 1990, P. L. 101-508, 104 Stat. 1388.