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Why No Advance Directive?

Why No Advance Directive? Abstract In their article, published in the April 15, 1994, issue of the Archives, Brooks et al state that their finding of limited availability of advance directives is "further evidence of a low level of physician involvement in this area." I think that this is a gross misstatement and it overlooks the whole host of cultural, religious, and personal reasons that influence elderly nursing home residents (and, indeed, community-dwelling elderly) to forego formal statement of their preferences. In my experience as a medical director of a nursing facility, a founding member of its ethics committee, and a personal physician to about a third of its residents, I have been repeatedly impressed by how often people do not wish to make formal advance directives. It is my practice to discuss this issue on first acquaintance and then, again, about 3 weeks later. Subsequently, the topic will be reintroduced if there is a References 1. Brooks S, Warshaw G, Hasse L, Kues JR. The physician decision-making process in transferring nursing home patients to the hospital. Arch Intern Med . 1994;154:902-908.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Why No Advance Directive?

Archives of Internal Medicine , Volume 155 (5) – Mar 13, 1995

Why No Advance Directive?

Abstract

Abstract In their article, published in the April 15, 1994, issue of the Archives, Brooks et al state that their finding of limited availability of advance directives is "further evidence of a low level of physician involvement in this area." I think that this is a gross misstatement and it overlooks the whole host of cultural, religious, and personal reasons that influence elderly nursing home residents (and, indeed, community-dwelling elderly) to forego formal statement of their...
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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1995.00430050127018
Publisher site
See Article on Publisher Site

Abstract

Abstract In their article, published in the April 15, 1994, issue of the Archives, Brooks et al state that their finding of limited availability of advance directives is "further evidence of a low level of physician involvement in this area." I think that this is a gross misstatement and it overlooks the whole host of cultural, religious, and personal reasons that influence elderly nursing home residents (and, indeed, community-dwelling elderly) to forego formal statement of their preferences. In my experience as a medical director of a nursing facility, a founding member of its ethics committee, and a personal physician to about a third of its residents, I have been repeatedly impressed by how often people do not wish to make formal advance directives. It is my practice to discuss this issue on first acquaintance and then, again, about 3 weeks later. Subsequently, the topic will be reintroduced if there is a References 1. Brooks S, Warshaw G, Hasse L, Kues JR. The physician decision-making process in transferring nursing home patients to the hospital. Arch Intern Med . 1994;154:902-908.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 13, 1995

References