Doctors Not Heeding Living Wills

Hypothetical survey finds patient's desires often superseded

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TUESDAY, July 27, 2004 (HealthDayNews) -- In a study using hypothetical cases, doctors commonly made treatment decisions for dying people that went against directions provided in a living will.

That's according to an article in the July 26 issue of the Archives of Internal Medicine.

Researchers devised a survey of six hypothetical cases describing patients with serious or life-threatening illnesses who had lost their decision-making capability. Each case also contained an explicit advance directive -- commonly known as a living will -- that potentially conflicted with either the prognosis, the wishes of family and friends, or the patient's quality of life.

In 65 percent of cases, decisions made by the doctors were not consistent with what the patient wanted. When physicians made decisions inconsistent with the advance directive, they were more likely to list reasons other than the directive for their decisions.

"Continuing improvement in the process of end-of-life decision making is needed," the authors concluded. "This process will have to recognize the inherent uncertainties in caring for seriously ill patients."

More information

The American Academy of Family Physicians has more about living wills.

SOURCES: Archives of Internal Medicine, news release, July 26, 2004


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