Matches and Mismatches Between Patients’ Preferences and Clinicians’ Perceptions

Better clinician understanding of patients’ end-of-life treatment preferences has the potential for reducing unwanted treatment, decreasing health care costs, and improving end-of-life care. Conclusion: Clinicians erred more often about patients’ wishes when patients did not want treatment than when they wanted it. Treatment decisions based on clinicians’ perceptions could result in costly and unwanted treatments. End-of-life care could benefit from increased clinician-patient discussion about end-of-life care, particularly if discussions included patient education about risks of treatment and allowed clinicians to form and maintain accurate impressions of patients’ preferences.

Lois Downey, MA, David H. Au, MD, MS, J. Randall Curtis, MD, MPH, and Ruth A. Engelberg, PhD