More Evidence of Surrogates More Aggressive than Patients Want

There is already a small mountain of literature documenting how the end-of-life treatment that surrogates request on behalf of incapacitated patients is more aggressive than the treatment that those patients would request for themselves.  Now, from Germany is yet another such study.  

In an article forthcoming in Journal of Medical Ethics (free access here) Professors Kuehlmeyer, Borasio, and Jox find a "discrepancy between the patients' wishes against prolongation of treatment and the surrogates' decisions to continue."  They focused on life-sustaining decisions for patients in a vegetative state.  

Professors Kuehlmeyer, Borasio, and Jox identify several reasons that a patient's prior treatment wishes are not respected.  First, some surrogates are hesitant to make irreversible decisions.  They "read meaning into the patient's involuntary behavior . . . to share or even delegate responsibility to the patient."  Second, some surrogates did not see ANH or administration of antibiotics as "medical treatment" that could be rejected.