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December 01, 2016

Health Care Decision-Making Research

David Godfrey

(The pdf for the issue in which this article appears is available for download: Bifocal, Vol. 38, Issue 2.)


The Commission is more than halfway through a major study of how health care providers make health care decisions for patients in a clinical setting who lack capacity and have nothing in writing naming a person to make health care decisions. This research project is made possible by funding from the Retirement Research Foundation. Joining us on the project are the Society for Hospital Medicine and the Society for Critical Care Medicine.

There are three parts to this project:

The first part of the project was a survey of health care providers asking detailed questions about how they assist patients with health care decision-making. Questions included: who do health care providers ask for consent from, how health care providers resolve conflicting opinions between family and friends regarding health care choices, the incidence of patients with no identifiable family or friends, and how health care providers resolve decision-making for this most vulnerable population. The survey was developed and tested over the first half of 2016, and data was collected over the summer. Data is currently being reviewed from over 500 responses to develop a report, findings, and recommendations.

The second element is the collection of hospital staff policies or guidance on health care decision-making. This element has proven difficult to collect, with only a couple of resources publicly available and only a handful submitted to our initial request. Additional follow-up is needed to create a meaningful collection of policies.

The third part is an expert round table scheduled for March of 2017 to discuss the findings and proposed recommendations. The panel of experts for the round table has been selected and invitations are being extended.
The outcome of this project will be a better understanding of clinical best practices and clinical practice compares to prevailing or emerging laws and policies. The final report will include recommendations for policy and training for health care providers and legal practitioners.

Where to Go for Further Information

For updates on this project, see the Commission’s Health Care Decision-Making Resources webpage at:

David Godfrey