Journal of the American Geriatrics Society
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A peculiar dynamic in communication exists between those who are most likely to be involved in life-prolongation decisions. We found that both the elderly and health care professionals talk about life-prolongation, but not with one another; that they consider some of the same factors as they think about the life-prolongation decision; and that most of them believe physicians should be responsible for initiating discussion. ⋯ The patient remains patient, waiting--with fears of dependency, memories of previous life-threatening experiences, and deep sensitivity for suffering--for the physician to initiate the discussion. Is a mediator such as a family member necessary in these situations? Is the hospital environment not conductive to discussion of less than heroic efforts?