Liz Dzeng
speaker
457 appearances
3 recordings
1 series
first heard Oct 2020
last heard Dec 2023
Liz Dzeng’s voice in public audio — every appearance, attributed to the second.
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Yeah.
And I think that's also reflected in um, you know, how we experience it as well.
And also the interviews that I've done with people is that actually having that autonomy without the guidance can be really stressful and very guilt.
You know, the the families can have a lot of guilt around these decisions and there's a huge burden of decision making.
Sometimes you kind of want the doctors to sort of consider what's in the patient's best interest and and guide the patient.
Yeah, so I thought what was most interesting about Andrea's study was um this this uh lack of difference between guardians and known surrogates or you know, family members and that sort of thing.
And I think that really highlights some of the things that we've already talked about that
You know, it's it's not that, you know, and and Andrew, you mentioned this that yours the surprising finding was that actually there was more aggressive care in in in people with family members who are making decisions.
And so that really points to how maybe there's just this culture of higher intensity care.
And I also thought it was interesting that in your study, um, there was a lot of the people were in high intensity regions, um, so areas of the country where there was more high intensity care.
And
um, you know, as a sociologist, um, I think about things on an institutional level and how institutional cultures
um and policies really influence this.
And so I think the main takeaway that I got from um this paper was that this just shows that a lot of what we're um a lot of the way that we act um isn't really based on how we know how well we know the patient and how we're able to like you know steer based on advanced care planning and uh advanced directives, but rather that the institutional culture
ha plays a huge part in things.
And so that's one aspect of it.
But also that there are flaws in advanced care planning and advanced directives.
And um like Alex said, we can refer to the previous podcast with John Morrison about that.
But also this concept of substituted judgment um and and this primacy of autonomy that we have in America, I think we need to rethink because you know none of us like
I mean, as doctors, we have a better sense of what goes on if someone is in the ICU, but somebody who's never had that experience just will have a really difficult time envisioning what that is.
Showing 341–360 of 457 · page 18 of 23
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