Spouse as health care proxy for dialysis patients: Whose preferences matter?

Rachel A. Pruchno, Edward P. Lemay, Lucy Feild, Norman G. Levinsky

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Purpose: We examined the extent to which the substituted judgments made by spouses of patients with end-stage renal disease actually reflect patient preferences. Design and Methods: We used data from 291 couples to compare dialysis patients' preferences for continuing hemodialysis under a variety of hypothetical situations with both substituted judgment data from spouses and information about spouses' own preferences. Results: Substituted judgments were more highly related to spouses' preferences than to patients' preferences. Implications: Findings raise questions about the extent to which the moral principle of patient autonomy should guide decision making at the end of life.

Original languageEnglish (US)
Pages (from-to)812-819
Number of pages8
Issue number6
StatePublished - Dec 2005
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Gerontology
  • Geriatrics and Gerontology


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