Cohort Studyhigh evidence
Patient versus surrogate decision making for life sustaining treatment and terminal care intensity.
American journal of respiratory and critical care medicine·June 12, 2026·PMID 42286341
Why it mattersPOLST and advance directives are widely used to honor patient autonomy in the ICU, but this study reveals that the signatory's identity critically influences end-of-life care intensity. Surrogate decision-makers may paradoxically increase invasive interventions, potentially overriding patients' prior wishes and undermining the goals of these documents.
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