When it comes to making end-of-life care decisions, a surprising number of surrogates of critically ill patients would prefer to make these decisions themselves—and without input from a physician, a new report indicates.

The majority of caregivers—56%—still prefer to make decisions in consultation with a physician, but that number is considerably lower than expected, according to researchers at the University of Pittsburgh Medical Center. The heavy emotional burden associated with making an end-of-life choice for someone else has led many in the medical community to assume caregivers and surrogates would prefer a doctor to weigh in on the decision. But a full 42% of surrogates surveyed said they would prefer to make the decision on their own.

The 169 study participants were surrogates of critically ill patients at San Francisco area intensive care units. They were shown two videos about end-of-life decisions making, one in which a doctor offered his advice and one in which he did not. The results led some doctors to suggest that physicians should ask whether their opinions are welcome, rather than assume it’s their responsibility. The report will appear in the August 15 edition of the American Journal of Respiratory and Critical Care Medicine.