Discordance in Prognosis Between Critical Care Physicians and Surrogate Decision-Makers Is Common

Patient and family perceptions of prognoses often differ from those of critical care physicians. Although we commonly attribute this discordance to poor communication, other factors might be in play, and overly optimistic perspectives can contribute to decisions that prolong the dying process.

Investigators in California enrolled dyads, each comprised of one or more surrogate decision-makers and an attending physician, for 174 patients who had been receiving mechanical ventilation for at least 5 days. Patients were predominantly non-Hispanic white or Asian/Pacific Islander as were their surrogates and the physicians. Surrogates were diverse in religious preferences and levels of education. Members of each dyad were asked to rate the patient'…