ER Patients Often Confuse Role of Emergency Contacts

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When a doctor requests emergency contact information, emergency room patients often assume they’re being asked for the person they’d like to make medical decisions for them, a new study indicates.

But, that’s a role that must be designated in a legal document called an advance directive.

Ninety-five percent of patients treated in the emergency room mistakenly believed their emergency contact is the person designated to make medical decisions about end-of-life care, according to the study from Henry Ford Hospital in Detroit.

The fact that doctors routinely ask their patients for emergency contact information without explaining what responsibilities this person has could help explain this common misconception. The study authors suggested that doctors could inadvertently be strengthening the idea that emergency contacts have more importance than the medical decision maker listed in an advance directive.

“We’re using an antiquated vocabulary in medicine,” study co-author Dr. Erin Zimny, a Henry Ford Emergency Medicine and Palliative Care physician, said in a hospital news release. “We should be asking and educating patients about the importance of an advance directive instead of defaulting to the emergency contact world.”

In 1991, the Patient Self-Determination Act was enacted to protect patients from unnecessary suffering, family hardship and inappropriate use of resources. The legislation also requires hospitals to inform all patients about their right to a natural death.

Advance directives describe adults’ preferences for their end-of-life care. Despite their significance, many patients have not completed one. Previous research revealed that although 60 percent of adults want their end-of-life preferences to be respected, only about one-third had an advance directive.

“What happens is a patient in respiratory distress or heart failure is too sick to tell us what they want, and when you look up their information in the medical record, most of the time nothing is documented,” said Zimny. “So we end up doing things in the most invasive way to keep them alive.”

In conducting the study, the researchers surveyed 308 emergency room patients treated between December 2012 and April 2013. Of these patients, 34 had an advance directive, but only half of them gave a copy of it to their primary care doctor.

Of those surveyed, only 43 percent said their emergency contact was their appointed medical decision maker.

The study was recently presented at the 20th International Congress on Palliative Care in Montreal. Research presented at medical meetings is considered preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institutes of Health provides more information on advance directives.

Source: HealthDay

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