Table 4.
Themes Related to Spokespersons' Intended Process for Future Surrogate Decision Making
| Theme | Quote |
|---|---|
| 1. Spokespersons intend to draw upon existing knowledge of patient wishes | “I have everything that he wants on paper, so in that situation, I can, in theory, remove myself from the emotional side of it and just say…this is what he would have wanted, and just do that” |
| “[The ACP conversations] made me feel like I could defend choices to other members of the family, particularly his daughters who are always the hardest ones” | |
| 2. Spokespersons intend to involve family, friends, and/or medical staff to aid in the decision making process | “Before the study, I basically already knew what she wants so it pretty much just helped me understand that I don't have to know by myself what she wants. Like the doctor is also included and can help me understand, OK, based on what she wants, whatever goes down, if he says, “this is what it is,” then we can kind of know what she wants then” |
| 3. Spokespersons intend to incorporate personal judgments based on their history and/or relationship with their loved one | “Because, the way I feel about her and, and as much as we been together…I know what's best for her. And I wouldn't want her to suffer, and I'd want her to be as comfortable as possible, without pain and not suffer.” |
| “Well [if my wife] had to go on a machine, she wouldn't want to. But for me, I would try anything to prolong her life. I wouldn't just want to see her deteriorate, not wanting to do it, not wanting to get the help she actually needs every time’” | |
| 4. Spokespersons intend to use guidance from religious or faith-based beliefs and teachings | “We still have to keep in mind the Catholic teaching of keeping the person comfortable and not doing anything that would terminate their life more quickly” |
| 5. Emotions can overpower rational decision making | “I think that it's hard because I feel like any kind of medical decisions are intensely personal and not always logical. The decision that you have to make is sometimes a combination of emotional and logical” |