Most individuals’ preferences regarding life-sustaining treatment do not appear to change over a three-year period, regardless of declines in physical and mental health, according to a report in the October 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. Individuals who say they want aggressive care and those without advance directives are most likely to change their end-of-life wishes over time. ‘Efforts to improve the experience of patients and families at the end of life must incorporate patient perspectives,’ the authors write as background information in the article. ‘Advance directives are one strategy through which patient preferences can be elicited and recorded, to be invoked at a time when the patient may not be able to make decisions directing care.’ However, they note, preferences for life-sustaining treatment given in one state of health may not reflect the choices patients would make if their health status changed. Marsha N. Wittink, M.D., M.B.E., of the University of Pennsylvania School of Medicine, Philadelphia, and colleagues assessed end-of-life preferences in 818 physicians (average age 69) who graduated from medical school at Johns Hopkins University between 1948 and 1964. Participants completed questionnaires about their health status and their end-of-life preferences […]