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Family Communication about End-of-Life Decisions and the Enactment of the Decision-Maker Role

Department of Communication, Saint Louis University, 3733 West Pine Blvd, Xavier 300, St. Louis, MO 63108, USA
Author to whom correspondence should be addressed.
Academic Editor: Maureen P. Keeley
Behav. Sci. 2017, 7(2), 36;
Received: 1 March 2017 / Revised: 12 May 2017 / Accepted: 2 June 2017 / Published: 7 June 2017
(This article belongs to the Special Issue Family Communication at the End of Life)
PDF [210 KB, uploaded 7 June 2017]


End-of-life (EOL) decisions in families are complex and emotional sites of family interaction necessitating family members coordinate roles in the EOL decision-making process. How family members in the United States enact the decision-maker role in EOL decision situations was examined through in-depth interviews with 22 individuals who participated in EOL decision-making for a family member. A number of themes emerged from the data with regard to the enactment of the decision-maker role. Families varied in how decision makers enacted the role in relation to collective family input, with consulting, informing and collaborating as different patterns of behavior. Formal family roles along with gender- and age-based roles shaped who took on the decision-maker role. Additionally, both family members and medical professionals facilitated or undermined the decision-maker’s role enactment. Understanding the structure and enactment of the decision-maker role in family interaction provides insight into how individuals and/or family members perform the decision-making role within a cultural context that values autonomy and self-determination in combination with collective family action in EOL decision-making. View Full-Text
Keywords: end-of-life decision-making; family roles; surrogate decision maker end-of-life decision-making; family roles; surrogate decision maker
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Trees, A.R.; Ohs, J.E.; Murray, M.C. Family Communication about End-of-Life Decisions and the Enactment of the Decision-Maker Role. Behav. Sci. 2017, 7, 36.

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