Stability of Patient Preferences for Life-Sustaining Treatment

We tend to assume that the preferences of patients with advanced chronic illness for (or against) life-sustaining treatment remain relatively stable over time. To determine whether this assumption is accurate, researchers at Yale University interviewed 189 community-dwelling patients (age ≥60) with advanced cancer, heart failure, or chronic obstructive lung disease.

Patients were interviewed at least every 4 months for 3 years or until death (one third of patients died at 1 year). The interviews assessed the patients’ willingness to (1) undergo highly burdensome treatment to avoid death, (2) risk physical disability to avoid death, and (3) risk cognitive disability to avoid death. Patients’ responses were classified as “consistent” (i.e., th…