End-of-life treatment preferences of persons with serious mental illness
Authors
Foti, Mary EllenBartels, Stephen J.
Van Citters, Aricca D.
Merriman, Melanie P.
Fletcher, Kenneth E.
UMass Chan Affiliations
Department of PsychiatryDocument Type
Journal ArticlePublication Date
2005-05-06Keywords
Acute DiseaseAdult
*Advance Directives
Female
Humans
Male
Massachusetts
*Mental Disorders
Middle Aged
Patient Participation
*Patient Satisfaction
Questionnaires
Terminal Care
Life Sciences
Medicine and Health Sciences
Metadata
Show full item recordAbstract
OBJECTIVE: The goal of this study was to ascertain preferences for end-of-life care among persons with serious mental illness. METHODS: The participants were 150 community-residing adults with serious mental illness. The Health Care Preferences Questionnaire was administered to obtain information about treatment preferences in response to hypothetical medical illness scenarios: use of pain medication in the case of incurable cancer and use of artificial life support in the case of irreversible coma. Participants were asked what their treatment preferences would be for an imaginary person in each scenario ("other") as well as their preferences for themselves ("self"). RESULTS: For the scenario involving pain medication for incurable cancer, most participants chose aggressive pain management even if cognition might be affected (64 percent of respondents under the "other" scenario and 66 percent under the "self" scenario). Few participants thought a doctor should provide patients with enough medication to end their life (34 percent for self and 24 percent for other). For the scenario involving irreversible coma, respondents were divided in their choice regarding life support. Approximately one-quarter said that they would prefer to immediately terminate life support (28 percent of respondents for other and 29 percent for self), and half said they would choose to turn it off after a defined period (48 percent for other and 45 percent for self). CONCLUSIONS: Persons with serious mental illness were able to designate treatment preferences in response to end-of-life health state scenarios. Future research is needed to test advance care planning methods, assess stability of choices over time, and ascertain the utility of scenario-based preferences to guide end-of-life care decisions in this population.Source
Psychiatr Serv. 2005 May;56(5):585-91. Link to article on publisher's siteDOI
10.1176/appi.ps.56.5.585Permanent Link to this Item
http://hdl.handle.net/20.500.14038/39028PubMed ID
15872168Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1176/appi.ps.56.5.585