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Study Reveals Cancer Patients' Views on Advanced Directives

Fewer than half had advanced directive, only minority wanted to discuss it with their oncologist

WEDNESDAY, Nov. 25 (HealthDay News) -- Seriously ill cancer patients may harbor attitudes toward advanced directives -- particularly with whom they wish to discuss them -- that appear paradoxical, according to research published online Nov. 23 in the Journal of Clinical Oncology.

Lindsay A. Dow, of the Virginia Commonwealth University in Richmond, and colleagues analyzed data from 75 patients admitted to a cancer inpatient service. Subjects responded to interviews regarding their history of discussions about advanced directives and their attitudes toward them.

The researchers found that fewer than half (41 percent) had completed an advanced directive. Seventy-five percent had discussed advanced directives with someone, but of those who discussed them with a physician, only 22 percent talked it over with their medical oncologist. Of the patients who had not discussed an advanced directive with their oncologist, only 23 percent felt they would like to do so. However, when asked to choose with whom they'd prefer to have the discussion, 48 percent picked their oncologist, 34 percent chose the primary care physician, and 11 percent chose the hospital's admitting physician.

"Many have an advanced directive discussion with a family member, but this does not always translate into completed documents that are communicated to their physicians," the authors write. "We suggest that primary care physicians, house staff, hospitalists, and oncologists need to be better trained to have these difficult discussions."

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