A Computer that dec|des |f we L|ve of D|e

LCnuCn Lngland (Cnn) A serlous ln[ury leaves a loved one ln a coma 8elaLlves may face Lhe hardesL
declslon of Lhelr llves Lo walL lL ouL or Lurn off Lhe llfesupporL machlne

1he program may help famllles declde whaL acLlon Lo Lake lf a loved one ls crlLlcally lll
8uL now LhaL crlLlcal declslon may be Lurned over Lo a sophlsLlcaLed compuLer program new sofLware
should soon be able Lo predlcL more accuraLely Lhan loved ones how comaLose paLlenLs would choose
Lo be LreaLed lf Lhey were able Lo make Lhe declslon Lhemselves

8loeLhlclsL uavld Wendler aL Lhe uS naLlonal lnsLlLuLes of PealLh ln WashlngLon uC and hls
colleagues used very elemenLary pasL research Lo bulld up paLLerns ln paLlenLs cholces 1here was very
llLLle daLa avallable and Lhe approach we used was lncredlbly slmpllsLlc Wendler concedes 8uL even
wlLh a llLLle amounL of daLa we dld very well

1he sLudy compared how accuraLely Lhelr compuLerbased Lool predlcLed a paLlenLs preferred
LreaLmenLs compared wlLh whaL loved ones sald 8esulLs showed boLh meLhods goL lL rlghL around Lwo
Lhlrds Lo LhreequarLers of Lhe Llme

Wendler hopes Lo bulld up a broader daLa bank of personal proflles whlch wlll lnclude age gender
rellglous and eLhnlc background Lo advance Lhe sofLware Pe ls confldenL LhaL wlll enable more
accuraLe paLlenL predlcLlons We have very good reason Lo belleve we can geL slgnlflcanLly beLLer
resulLs Wendler says Maybe Len or flfLeen percenL more accuraLe Lhan (nexL of kln)

aLlenLs have galned more conLrol over Lhelr medlcal care ln recenL years buL many sLlll fall Lo slgn a
dlrecLlve looklng Lo Lhe fuLure lew dlscuss LreaLmenL preferences Lhey would elecL lf Lhey losL Lhe
ablllLy Lo make declslons WlLhouL a selfdlrecLed advance medlcal plan for a paLlenL relaLlves are ofLen
asked Lo sLep ln and acL on a loved ones behalf

Weve always gone wlLh Lhe ldea LhaL people who know Lhe paLlenL besL are also besL poslLloned Lo
make Lhe declslon abouL LreaLmenL Wendler says My concerns were LhaL Lhls process puLs a burden
on famllles l wanLed Lo develop an alLernaLe approach


Wendler ls acuLely aware of Lhe problems a sofLware program llke Lhls mlghL pose for Lhe communlLy aL
large Some people say of course Lhls ls good and oLhers Lhlnk Lhls ls crazy Wendler says

uonL Mlss
1he fuLure of healLh
ls nanoLechnology Lhe key Lo curlng cancer?
lnLervlew naoml Palas
lrrespecLlve of medlcal advances some relaLlves may on prlnclple always wanL Lo make endofllfe
LreaLmenL declslons for lncapaclLaLed relaLlves CLhers may prefer Lo see Lhe compuLergeneraLed
resulLs Lo help Lhem come Lo a declslon We could glve Lhem supplemenLary lnformaLlon llke people
llke your faLher wanL Lhls klnd of LreaLmenL Wendler says 1haL exLra lnformaLlon mlghL dlmlnlsh
doubLs or offer supporL Lo an overwhelmed famlly member 8esulLs wlll be dlfferenL dependlng on lf
Lheyre LwenLy or nlneLy yearsold Wendler adds or lf Lhe LreaLmenL Lhey face ls a LasLeless plll versus
palnful chemoLherapy or lnvaslve surgery

1he compuLer Lool could also poLenLlally replace Lhe relaLlve or nexL of kln aLlenLs could choose Lhls
opLlon ln advance of Lhelr degeneraLlon lnsLead of Lurnlng over Lhe declslon Lo a loved one Some may
see lL as unburdenlng famlly or slmply more accuraLe 1here ls also Lhe segmenL of paLlenLs who do noL
have surrogaLes who can acL on Lhelr behalf

lor Wendler and hls Leam Lhe nexL sLep ls a broad poll and Lo reflne Lhe compuLer model As Lhe head
of Lhe unlL on vulnerable opulaLlons ln Lhe ueparLmenL of 8loeLhlcs ln Lhe nlP Cllnlcal CenLer uave
Wendler undersLands Lhe need Lo keep hls work LransparenL ueveloplng a communlLybased process ls
essenLlal he says oor nonempowered groups are worrled Lhls process wlll be used Lo cuL off
LreaLmenLs 8uL l am Lrylng Lo ldenLlfy whaL ls Lhe besL way Lo make declslons for Lhese paLlenLs