Physician's Behavior in Withdrawing and Withholding Life Sustaining Treatment: Are Patient's Advance Directives Being Followed?

Patient Self Determination Act of 1990;advance directive;documentation;life support;Public Administration

Brown, PaulFlint ;

University of Michigan

关键词: Patient Self Determination Act of 1990;    advance directive;    documentation;    life support;    Public Administration;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/143414/BrownP.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

The Patient Self Determination Act of 1990 was intended to ensure that patients over the age of 18 were informed of their rights to accept or refuse medical care and to improve communication between the patient and physician regarding this right. A study of 192 medical records at a 423 bed hospital in eastern Michigan found that 97% of the physicians recording in the patient;;s medical record honored their patient;;s wishes as expressed in their advance directive. More than fifty percent of the physicians did not document in the medical record that they communicated with the patient about withdrawing or withholding life support technology. Nineteen percent did not write orders for withdrawing or withholding life support technology in the medical record as required by the patient;;s advance directive. This study concluded that physicians followed patient;;s wishes the majority of the time, but did not appropriately document in the medical record evidence that they had communicated with the family regarding advance directives or treatment options. Statistical analysis showed that there was no correlation between physician;;s natural origin, type of practice, years in practice, patient;;s gender and patient;;s age and whether or not the physician documented communication with the patient in the patient;;s medical record.