Default Options in Advance Directives for Patients with Serious Illnesses
Most Americans wish to avoid aggressive, end-of-life care. However, choosing comfort-oriented care can be emotionally and existentially challenging. Informed by a pilot study published in Health Affairs in 2013, this research project is a multi-center, randomized trial to determine whether structuring advance directives such that patients indicate preferences for comfort-oriented care by default can improve patients’ outcomes near the end of life. By enrolling patients with a range of incurable diseases, the research team will determine whether this scalable intervention can improve patients’ quality of life and reduce resource utilization, without reducing the number of days that patients are alive and living outside of the hospital.