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Margaret L Schwarze, MD performed a nationwide survey of more than 900 vascular, cardiothoracic and neurological surgeons, and discovered that 60 percent said they would either sometimes or always refuse to operate on a patient who explicitly stated a desire to limit life-supporting treatments for a life-threatening postoperative complication. A similar number (62%) said they would preoperatively create an informal contract with patients outlining agreed-upon limits of aggressive postoperative treatments. The results of the survey were published online recently in the journal Critical Care Medicine (

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