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Evidence suggests that implicit contracts exist between surgeons and their patients that commit patients to aggressive postoperative treatments. To assess surgeons' beliefs and practices about life support after high-risk surgery, investigators surveyed more than 900 randomly selected vascular, neurological, and cardiothoracic surgeons, all of whom performed at least one high-risk surgery monthly. Results were published in two separate papers.
Respondents were asked to imagine a patient who required nonemergent surgery, who was at moderate risk for long-term postoperative ventilatory support or dialysis, and who specifically requested limitation of postoperative life-sustaining therapy (e.g., ventilatory support, dialysis). More than 70% of …