Wendler D, Rid A (2011): Systematic Review: The Effect on Surrogates of Making Treatment Decisions for Others. Annals of Internal Medicine 154(5): 336-46
Wendler and Rid review studies of the effects of treatment decisions on the surrogates who make them. Eleven quantitative studies and 29 qualitative studies involving surrogates, most of whom had made end-of-life decisions for incapacitated adults, found that many surrogates experienced a negative emotional burden associated with the decision. Negative effects typically lasted months or years and included stress, guilt, and doubt. Future research should evaluate ways to reduce the emotional burden that surrogates experience after decision making.