A new survey published in the Annals of Surgery reveals that many surgeons fail to discuss their patients’ wishes in case a risky operation goes awry and even more surgeons would not operate if patients limited what could be done to keep them alive. Margaret Schwarze, an assistant professor at the University of Wisconsin School of Medicine and Public Health, and her colleagues asked 912 surgeons who regularly perform risky operations 14 questions on how they discuss a patient’s advance directives. More than four out of every five surgeons discussed which forms of life support the patients would like to limit but only about half asked specifically about the patient’s advance directive, which can include restricting the use of feeding tubes and ventilators. More than half of the surgeons surveyed reported that they would not operate if an advance directive limited what could be done to keep a patient alive after surgery. The researchers said such instructions can cause tension between the surgeon and the patient because it shows the patient may be unwilling to accept the therapies that come with high-risk operations. Ann Surg. 2011 Dec 1. PMID: 22167006
