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Ethnicity and Advance Care Directives

Published online by Cambridge University Press:  01 January 2021

Sheila T. Murphy ,
Joycelynne M. Palmer ,
Stanley Azen ,
Gelya Frank ,
Vicki Michel  and
Leslie J. Blackhall
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Extract

Advance care directives for health care have been promoted as a way to improve end-of-life decision making. These documents allow a patient to state, in advance of incapacity, the types of medical treatments they would like to receive (a living will), to name a surrogate to make those decisions (a durable power of attorney for health care), or to do both. Although studies have shown that both physicians and patients generally have positive attitudes about the use of these documents, relatively few individuals have actually completed one.

What underlies this discrepancy between attitudes and behavior with regard to advance care directives? One obvious explanation is lack of access. Emanuel et al. estimated that approximately 90 percent of the population desire an advance care directive, and they pointed to access as the major barrier. Yet interventions that increase accessibility have typically failed to yield more than a 20 percent completion rate. Thus, it appears that access is not the sole determinant of advance care directive completion.

Type
Article
Information
Journal of Law, Medicine & Ethics , Volume 24 , Issue 2 , Summer 1996 , pp. 108 - 117
Copyright
Copyright © American Society of Law, Medicine and Ethics 1996

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References

Davidson, K.W. et al., “Physicians Attitudes on Advance Directives,” JAMA, 262 (1989): 2415–19; Emanuel, L.L. et al., “Advance Directives for Medical Care—A Case for Greater Use,” N. Engl. J. Med., 324 (1991): 889–95; Finucane, T.E. et al., “Planning with Elderly Outpatients for Contingencies of Severe Illness: A Survey and a Clinical Trial,” Journal of General Internal Medicine, 3 (1988): 322–25; Lo, B. McLead, G.A. Saika, G., “Patient Attitudes to Discussing Life-Sustaining Treatment,” Archives of Internal Medicine, 146 (1986): 1613–15; and Shmerling, R.H. et al., “Discussing Cardiopulmonary Resuscitation: A Study of Elderly Outpatients,” Journal of General Internal Medicine, 3 (1988): 317–21.Google Scholar
Brennan, T.A., “Ethics Committees and Decisions to Limit Care: The Experience at the Massachusetts General Hospital,” JAMA, 260 (1988): 803–07; Gamble, E.R. McDonald, P.J. Lichstein, P.R., “Knowledge, Attitudes and Behavior of Elderly Persons Regarding Living Wills,” Archives of Internal Medicine, 151 (1991): 277–80; and Readleaf, D.L. Schmitt, S.B. Thompson, W.C., “The California Natural Death Act: An Empirical Study of Physicians' Practices,” Stanford Law Review, 31 (1979): 913–45; and Smedira, N.G. et al., “Withholding and Withdrawal of Life Support from the Critically III,” N. Engl. J. Med., 322 (1990): 309–15.CrossRefGoogle Scholar
Emanuel, et al., supra note 1.Google Scholar
Hare, J. Nelson, C., “Will Outpatients Complete Living Wills? A Comparison of Two Interventions,” Journal of General Internal Medicine, 6 (1991): 41–46.CrossRefGoogle ScholarPubMed
Jacobson, J.A. et al., “Patients' Understanding and Use of Advance Directives,” Western Journal of Medicine, 16 (1994): 232–36.Google Scholar
Sachs, G.A. Stocking, C.B. Miles, S.H., “Empowerment of the Older Patient? A Randomized Controlled Trial to Increase Discussion and Use of Advance Directives,” Journal of the American Geriatric Society, 40 (1992): 269–73.CrossRefGoogle Scholar
Emanuel, et al., supra note 1.Google Scholar
Klessig, J., “The Effect of Values and Culture on Life-Support Decisions,” Western Journal of Medicine, 157 (1992): 316–22; and Caralis, P.V. et al., “The Influence of Ethnicity and Race on Attitudes Toward Advance Directives, Life-Prolonging Treatments and Euthanasia,” Journal of Clinical Ethics, 4 (1993): 155–66.Google Scholar
Teno, J.M. et al., “The Use of Formal Prior Directives Among Patients with HIV-Related Diseases,” Journal of General Internal Medicine, 5 (1990): 490–94.Google Scholar
Sugarman, J. Weinberger, M. Samsa, G., “Factors Associated with Veterans' Decisions about Living Wills,” Archives of Internal Medicine, 152 (1992): 343–47.CrossRefGoogle Scholar
Lynn, J. Teno, J.M., “After the Patient Self-Determination Act: The Need for Empirical Research on Formal Advance Directives,” Hastings Center Report, 23, no. 1 (1993): 20–24.CrossRefGoogle Scholar
Katz, S. et al., “Studies in Illness in the Aged: The Index of ADL, a Standardized Measure of Biological and Psychosocial Function,” JAMA, 185 (1963): 914–19.CrossRefGoogle Scholar
Marin, G. et al., “Development of a Short Acculturation Scale of Hispanics,” Hispanic Journal of Behavioral Science, 9 (1987): 183–205.CrossRefGoogle Scholar
James, S.A. et al., “The Edgecombe High Blood Pressure Control Program, 11: Barriers to the Use of Medicaid Care Among Hypertensives,” American Journal of Public Health, 74 (1984): 468–72.CrossRefGoogle Scholar
Blackball, L.J. et al., “Ethnicity and Attitudes Toward Patient Autonomy,” JAMA, 274 (1995): 820–25.CrossRefGoogle Scholar
Id.Google Scholar
The SUPPORT Principal Investigators, “A Controlled Trial to Improve Care for Seriously Ill Hospitalized Patients,” JAMA, 274 (1995): 1591–98.CrossRefGoogle Scholar
Blackball, et al., supra note 15.Google Scholar