End-of-Life Decisions Can Have Serious Ramifications for Mental Health
Death is difficult. Most of us would struggle with choosing our own time to go, so how hard must it be to make that decision for someone else?According to new research, end-of-life medical decisions, whether choosing to stop treatment or discontinue life support, can cause relatives or friends of incapacitated patients to suffer for months or even years afterward, the Los Angeles Times reported.
The surrogate decision-makers often experience anguish and uncertainty over whether their decision was really what the patient would have wanted. Also, they may have to face the varying opinions of other relatives or friends of the patient.
It is common practice in hospitals to have designated others step in and make the life-or-death call when the patient is unable to do so. According to the National Institute of Health, 40 percent of hospitalized patients cannot make decisions for themselves. When the patient is elderly, that figure rises to 70 percent, and for the critically ill, 95 percent.
The researchers pooled together 40 studies on the topic involving 2,854 surrogates. Though a few studies showed surrogates can sometimes be satisfied with their decisions, the majority were less positive. One-third of patients experienced negative emotions after the experience, and often they were “substantial” and sustained for months.
The common emotions surrogates expressed were guilt, stress, and doubt. Some described the experience as “painful”, “traumatic”, “overwhelming” or even “the hardest thing I have ever done in my life.”
Researchers did find that the decision was less stressful for surrogates when the patient’s preferences were made clear through a living will or previous conversations.