ore than a third of seriously ill patients who requested that doctors ease their discomfort instead of prolonging their lives appear to have had their wishes overlooked, a new study reports.

The findings were based on a study of 1,185 Medicare patients at five teaching hospitals across the country who were suffering illnesses like multiple organ failure, cancer and congestive heart failure.

The researchers, who report their findings in the current Journal of the American Geriatrics Society, were unable to review the patients' medical files directly. Instead, they asked the patients whether they had expressed a treatment preference and whether the hospital appeared to be following their wishes.

But evidence supported the patients' belief that doctors were trying to prolong their lives, despite their wishes, said the lead author of the study, Dr. Joan M. Teno of Brown University. The patients had higher medical bills and lived longer than comparable patients who thought their wishes were being respected.

About 60 percent of patients said they wanted doctors to focus on making them comfortable. "Our findings suggest that physicians are unaware of their patients' preferences or, worse, that they are actively ignoring them," the authors wrote.