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