In one of our studies of patients with incurable cancer, people who did not see the video were generally not knowledgeable about their options. Three-quarters chose to die in hospitals. However, among patients who viewed the video and were fully informed about their choices, over 90 percent preferred to forgo aggressive interventions to die at home. This is also true for patients making decisions about advanced Alzheimer’s disease, patients being admitted to nursing homes, and even surrogates making decisions for their loved ones.
Videos can improve patient-doctor discussions and better inform decision-making. When people are better informed, most prefer to avoid invasive procedures, yet we doctors routinely provide unwanted care at the end of life. But, no one is served by providing care that goes against an informed and competent patient’s wishes.