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Catalysts for Conversations About Advance Directives: The Influence of Physician And Patient Characteristics

Published online by Cambridge University Press:  01 January 2021

Jeremy Sugarman ,
Nancy E. Kass ,
Ruth R. Faden  and
Steven N. Goodman
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Extract

Recent legislation, such as the Patient Self-Determination Act, establishes advance directives as an acceptable procedural means of incorporating patients’ preferences for life-sustaining treatments into their medical care. Advance directives can enhance medical decision making since they provide patients with an opportunity to communicate their preferences before suffering from an acute illness that may preclude their ability to do so.

Although patients expect discussions about life-sustaining therapies to be initiated by their physicians, very little is known about what prompts physicians to discuss advance directives with their patients. As in other areas of clinical decision making, there is evidence that patients’ sociodemographic factors influence whether discussions about advance directives occur between patients and their physicians. In one study of persons with the acquired immunodeficiency syndrome (AIDS), those who had not had discussions about advance directives with their physicians tended to be non-white, have no prior hospitalization, and were more likely to have been cared for in a health maintenance organization than in a teaching hospital.

Type
Article
Information
Journal of Law, Medicine & Ethics , Volume 22 , Issue 1 , Spring 1994 , pp. 29 - 35
Copyright
Copyright © American Society of Law, Medicine and Ethics 1994

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References

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