Majesko et al identifiied factors that can help to identify a family member who may struggle in the role of a surrogate decision maker. The authors are from the University of Pittsburgh.


Subject selection: family member of a patient in the intensive care unit


Factors associated with difficulty in being a surrogate decision maker from multivariate analysis:

(1) The family member has not had a discussion with the patient about treatment preferences.

(2) The family member does not have experience as a surrogate decision maker.

(3) The communication between the family member and the critical care physician is poor.


Additional factors associated with difficulty in role as surrogate decision maker, from univariate analysis (Table 4):

(1) male gender

(2) poor trust of the critical care physician

(3) not being the spouse


Additional factors that might influence the family member (not listed in Table 4):

(1) The family member does not want to be a surrogate decision maker.

(2) There is conflict between family members about what care is to be given.


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