One / Holding Life and Death in Their Hands
Is This for Me?
Two / The Intensive Care Unit
Personnel
Rhythms
Economics
Conclusion
Three / Actors
Patients
Friends, Family, and Significant Others
Health Care Professionals
Conclusion
Four / Decisions
Informed Consent
Venues
Affect
Conflict
Conclusion
Five / Prognosis
Evidence
Timing
Mixed Messages
Negotiation
Accuracy
Prognostic Framing
Conclusion
Six / Decision-Making Scripts
The Legal Script
Cognitive Scripts
Conflicts of Interest
Law at the Bedside
Conclusion
Seven / Improvisation: Decisions in the Real World
The Patient Should Decide
Reprising Patient Instructions
Standing in the Patient’s Shoes
Beneficence
It’s God’s Decision
What We Want
Denial, Opting Out
Conclusion
Eight / Making a Difference?
The Role of Physicians
Opting for a Trajectory
Outcomes
I Thought the Law Would Take Care of This
Does Any of This Matter?
Nine / The End
Implications
Before It’s Too Late
When It’s Too Late
When “This” Happens to Me
Appendix A: The Research
Appendix B.1: Patient Occupation
Appendix B.2: Patient Age, Gender, and Marital Status
Appendix B.3: Location and Purpose of Observed Meetings
Appendix C: Relationship between Multiple Trajectories Traversed
Appendix D: Decision Trajectory by Patient and Surrogate Characteristics
Appendix E: Advance-Directive Status and Aspects of the Decision-Making Process, Outcome, and Impact
Acknowledgments
Notes
References
Index