Project Overview +

The goal of this study is to determine if Advanced Directives (ADs) are completed more frequently when the rationale for doing so is communicated as a means to reducing surrogate decision-making burdens, rather than as a means of promoting patient autonomy.

Aims +

Aim 1. To more definitively establish the influence of communication strategies on completion rates of ADs

Aim 2. To evaluate the influence of default options embedded in ADs on cancer patients' preferences for life-prolonging versus comfort-maximizing therapies

Aim 3. To quantify the effects of these dual interventions on patients' mortality, rates of admission to ICUs, hospice utilization, costs of care, satisfaction with advance care planning, and their family members' perceptions of their quality of death and dying and their bereavement outcomes

Participants +

180 patients with Stage IIIB or IV non-small-cell lung cancer.

Intervention +

Patients learn the rationale of advanced directives in one of two ways: as a means to reducing surrogate decision-making burdens versus as a means of promoting patient autonomy.

Advanced Directives Among Patients With Lung Cancer

09/01/2011 - 08/31/2012


National Cancer Institute

Principal Investigator:

Scott D. Halpern, MD, PhD


Joseph N. Cappella, PhD
Angela Fagerlin, PhD
George Loewenstein, PhD
Kevin G. Volpp, MD, PhD