Phrasing Affects Do Not Resuscitate Choices


Researchers at the University of Pittsburgh recently studied what factors affect the decisions of people who are designated health care surrogates for a loved one. The researchers showed 252 people a video simulation of an actor posing as a doctor appraising them of a certain health condition and asking whether the patient should be resuscitated. They found that the way information is phrased makes a significant difference in what the health care surrogate chooses.

The study, developed in part by Dr. Amber Barnato and published in Critical Care Medicine, found that two factors made the biggest difference in the decision. One factor was whatever the health care surrogate believed other people in the same situation had chosen. When people were told that most people want CPR to be performed if the patient’s heart stopped in a certain situation, 64 percent also wanted CPR to be tried. If they were told that most people do not choose for CPR to be performed, then only 48 percent chose CPR.

The other significant factor was whether the “doctor” in the video used the phrase “allow a natural death” rather than the phrase “do not resuscitate.” When the latter phrase was used, 61 percent chose for CPR to be performed, but that figure dropped to 49 percent when the phrase “allow a natural death” was used.

Other factors had little effect. Expressions of sympathy from the “doctor,” being shown a photo of the loved one, or being asked to think about the choice from the perspective of the loved one all made little or no difference in the choice.


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