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Children Stick With Decisions Made About Dying Parents

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WebMD Health News

Dec. 3, 1999 (Atlanta) -- They made their decisions under a time of extreme stress, but Israeli researchers have found that, by and large, a group of adult children whose parents were dying 6 years ago don't regret the past medical choices they made for their loved ones. But at the same time the study finds that many of these children had no idea what their parents' wishes were in the first place.

"Fifty percent did not know what ... their parents wanted," says Moshe Sonnenblick, MD, a study author from the Department of Geriatrics at the Shaare Zedek Medical Center in Jerusalem. "They never discussed it. The parents never even mentioned it."

Sonnenblick says another reason offspring in Israel can be burdened with life and death decisions is that living wills -- which spell out a parent's wishes in the event of a terminal illness -- are rare in that country, with just 1% to 2% of patients having them.

The study, which appears in the latest issue of The Journal of the American Geriatric Society, was split into two phases. The first took place 6 years ago, when researchers interviewed the children of 48 terminally ill patients, to test their attitudes towards three "life-sustaining" medical issues. These included the DNR or 'do not resuscitate' order, the continuance of food and medicine, and euthanasia.

Six years later, the researchers located about half of those surveyed and interviewed them again. While some expressed second thoughts about what they'd decided for their parents, overall attitudes toward life-sustaining measures didn't change. There was continued support for feeding and medicating dying patients -- but at the same time, not resuscitating them if they stopped breathing -- as well as overwhelming opposition to euthanasia.

Where significant differences did crop up was in a separate group that had not gone through the death of a close relative. Twice the number of these people -- nearly 50% -- said they would request a DNR order, and almost twice as many said they would request euthanasia. But the researchers found that about half in that group had never discussed these options with the very people they would affect the most -- their parents.

The study results are no surprise to Norman Ables, Ph.D., professor of psychology at Michigan State University and past president of the American Psychological Association. "These are such excruciating decisions made under such stressful situations, it seems most people wouldn't want to change their minds about it," he says -- mainly because people want to believe they did the right, best thing for their loved one.

"The difficulty, of course, is you can't always tell when the end of life is going to occur," he adds, as some terminally ill patients can linger for weeks or even months.

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