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False memories and end-of-life treatment decisions

A major collaborative study shows that false memories can play a significant role in the discrepancy between people’s preferences for end-of-life treatment and their instructions in their living will.

Dr Maryanne Garry, a researcher at Victoria's School of Psychology, contributed to a collaborative study of more than 400 adults above the age of 65 alongside academics at the University of California, Irvine, Queen's University (California) and the University of New South Wales (Australia).
Their study, published in the current issue of the American Psychological Association journal Health Psychology, shows that preferences for life-sustaining treatments such as tube-feedings and CPR often change as people age or experience new health problems.
Dr Garry says that while the documentation for living wills—also called advance directives— typically reminds people of their right to update their directives if their wishes change, this assumes that people recognise when their wishes have changed, and remember that their current wishes are different from those documented in their living will. The study participants were interviewed about which life-sustaining treatments they would want if they were seriously ill, and were interviewed again 12 months later to test their recall of earlier decisions. About one-third of participants changed their wishes regarding medical treatment over the course of the year, and in 75 per cent of these cases, participants falsely remembered that their original views on the issues matched their new ones. Interviewers also talked to people with the authority to make medical decisions on behalf of the study subjects if they were no longer able to. Dr Garry says these potential surrogate decision-makers were even less sensitive to changes in their loved one’s wishes, showing false memories in 86 per cent of cases.

Dr Garry and her colleagues recommend that living wills have an expiration date that would prompt a review of end-of-life treatment directives. On a more personal level, the researchers stressed the importance of maintaining an ongoing dialogue among patients, their families and their physicians about end-of-life treatment options.

The study was conducted by Dr Garry, Dr Stefanie Sharman of the University of New South Wales (a Victoria graduate), Assistant Professor Jill Jacobson of Queen’s University, and Professors Peter Ditto and Elizabeth Loftus of the University of California at Irvine.

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