![]() ![]() Autonomy in medical decision making is tricky, and the line between supporting the decision-making process and pushing your agenda is blurred. The researchers found that "patients who reported choosing dialysis over conservative management to please doctors or family members" were 2.34 times more likely to regret their decisionĪs the researchers point out in their discussion, family, and perhaps physicians overtly or covertly nudged patients towards choices they in which they were not fully invested. It is a high hurdle to say out loud that your loved one, parent, sibling, or child is better seeking a peaceful end than continuing to fight the good fight. The second factor was that the person making the decision was often actually or virtually a family member or the physician. Patients whose doctors did discuss prognosis were 0.42 times less likely to feel regret, comparable to patients who had completed a living will and had already considered these issues. You might simplify this as a former of "buyer's regret" when you have not done your due diligence. First, the patients felt less need to "acquire detailed knowledge about the medical condition." That knowledge includes the length and quality of their future life (prognostic information), and information of end-of-life issues either concerning "dialysis withdrawal options," or the presence of some form of a living will. The researchers uncovered two factors that resulted in more regret. If you wonder why there would be anyone with regret at all, remember, not starting or continuing dialysis means that, barring a kidney transplant, you will die a "peaceful" death in the next few weeks. Researchers surveyed patients in several dialysis centers around Cleveland, asking among the questions, "Do you regret your decision to start dialysis?" Of the 423 participants, 88% answered that question. Which would you choose? More importantly, why would someone regret the decision to choose life? The development of dialysis, much like the development of insulin, changed a death sentence into a livable condition. ![]() "Regret is a negative cognitive or emotional state that involves blaming ourselves for a bad outcome, feeling a sense of loss or sorrow at what might have been, or wishing we could undo a previous choice that we made." Īs a clinician, I can report that regret is a powerful emotion and one that is almost impossible to alter. ![]()
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