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The Patient Self-Determination Act and Advance Directives: Snapshots of Activities in a Tertiary Health Care Center

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Abstract

This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs.

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REFERENCES

  • Creco, P.J., Shulman, K.A., Lanizzo-Maurey, R., Hansen-Flaschen, J. The Patient Self-Determination Act or the Future of Advance Directives. Annals of Internal Medicine, 1991; 115:639–643.

    Google Scholar 

  • Cruzan v. Director, Missouri Dept. of Health, 111 L.Ed. 2d 224, 110 S. Ct. 2841, 58 U.S.L.W. 4916 (U.S., June 26, 1990).

  • Emanuel, E.J. Cost savings at the end of life: What do the data show? Journal of the American Medical Association 275: June 26, 1996, pp. 1907–14.

    Google Scholar 

  • Emanuel, L.L., Barry M.J., Emanuel, E.J., and Stoeckle, J.D. (1994): Advance Directives: Can Patients' Stated Treatment Choices Be Used to Infer Unstated Choices? Medical Care 32(2), 1994, 95–105.

    Google Scholar 

  • Emanuel, L.L., Emanuel E.J., Stoeckle, J.D., Hummel, L.R. and Barry, M.J. Advance Directives: Stability of Patients' Treatment Choices. Archives of Internal Medicine 154: Jan. 24, 1994, pp. 209–217.

    Google Scholar 

  • Hakim, R.B., Teno, J.M., Harrell, F.E., Knaus, W.A., Wenger, N., Phillips, R.S., Layde, P., Califf, R., Connors, A.F., and Lynn J. For the Support Investigators. Annals of Internal Medicine, 1996, 125(4), 284–93.

    Google Scholar 

  • King, N.M.P. Making Sense of Advance Directives. Boston: Kluwer Academic Publishers, 1991.

    Google Scholar 

  • Lynn, J. Scholar Examines Treatment of Patients Who Are Dying. Chronicle of Higher Education March 22, 1996.

  • Lynn, J., Terro, T.M. After the Patient Self Determination Act. The need for empirical research or formal advance directives. Hastings Center Report 1993; 23:20–24.

    Google Scholar 

  • Omnibus Reconciliation Act of 1990. Public Law no. 101-508.

  • Schneiderman, L.J., Teetzel H. And Kalmanson, A.G. Who Decides Who Decides? When Disagreement the Physician and the Patient's Appointed Proxy About the Patient's Decision-Making Capacity. Archives of Internal Medicine 155:April 24, 1995, pp. 793–79.

    Google Scholar 

  • The Support Investigators. A Controlled Trial to Improve Care for Seriously Ill Hospitalized Patients, Journal of American Medical Association, 274 (No. 20), 1995, 1591–98.

    Google Scholar 

  • Teno, J.M., Hill, T.P. and O'Connor, M.A. Advance Care Planning, Priorities for Ethical and Empirical Research. Special Supplement, Hastings Center Report, November–December, 1994.

  • Wolfe, S.M., Boyle, P., Cullahan, D., Fins, J.J., Jennings, B., Nelson, J.L., Barondess, J.A., Brock, D.W., Dresser, R., Emmanual, L., Johnson, S., Lantos, J., Mason, D.R., Mezel, M., Orentlicher, D. and Rouse, F. Sources of Concern about the Patient Self-Determination act. New England Journal of Medicine, 1991; 325(23): 1666–1671.

    Google Scholar 

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Engel, J.D., Kane, G., Jones, D.L. et al. The Patient Self-Determination Act and Advance Directives: Snapshots of Activities in a Tertiary Health Care Center. Journal of Medical Humanities 18, 193–208 (1997). https://doi.org/10.1023/A:1025689719127

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