Clinical InvestigationsQuality of Life and Recommendations for Further Care*Putman, Michael S. MD1; Tak, Hyo Jung PhD2; Curlin, Farr A. MD3; Yoon, John D. MD1,4Author Information 1Department of Medicine, The University of Chicago, Chicago, IL. 2Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha, NE. 3Duke University, Trent Center for Bioethics, Humanities, and History of Medicine, Durham, NC. 4MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL. *See also p. 2109. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (http://journals.lww.com/ccmjournal). Supported by a grant from the John Templeton Foundation. The authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: email@example.com Critical Care Medicine: November 2016 - Volume 44 - Issue 11 - p 1996-2002 doi: 10.1097/CCM.0000000000001846 Buy SDC Metrics Abstract Objectives: Physician recommendations for further medical treatment or palliative treatment only at the end of life may influence patient decisions. Little is known about the patient characteristics that affect physician-assessed quality of life or how such assessments are related to subsequent recommendations. Design, Setting, and Subjects: A 2010 mailed survey of practicing U.S. physicians (1,156/1,878 or 62% of eligible physicians responded). Measurements and Main Results: Measures included an end of life vignette with five experimentally varied patient characteristics: setting, alimentation, pain, cognition, and communication. Physicians rated vignette patient quality of life on a scale from 0 to 100 and indicated whether they would recommend continuing full medical treatment or palliative treatment only. Cognitive deficits and alimentation had the greatest impacts on recommendations for further care, but pain and communication were also significant (all p < 0.001). Physicians who recommended continuing full medical treatment rated quality of life three times higher than those recommending palliative treatment only (40.41 vs 12.19; p < 0.01). Religious physicians were more likely to assess quality of life higher and to recommend full medical treatment. Conclusions: Physician judgments about quality of life are highly correlated with recommendations for further care. Patients and family members might consider these biases when negotiating medical decisions. Copyright © 2016 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.