Advance directives have been studied in different patient populations and institutions.
Most reports have shown limited use and little medically observable effect.
To our knowledge, no previous study has focused on the use of advance directives by individuals who have died or how their family members perceived the documents'effect.
We contacted informants listed on Utah Death Certificates from 1992 to estimate the prevalence and effect of advance directives.
Eighty-two percent of 1398 informants we contacted agreed to our telephone interview.
More than 50% of decedents reportedly completed an advance directive.
Individuals older than 65 years (57.3%), women (58.1%), nursing home residents (63.4%), and hospice users (75.2%) were most likely to have had advance directives.
Education, religion, religiosity, and location had no effect on prevalence.
Most informants stated that advance directives had no effect on the decedent's care, but a minority felt they helped to limit treatment.
Do-not-resuscitate orders were written more often for patients with advance directives.
Feeding tubes were removed more often from decedents with living wills than from other decedents.
Mechanical ventilatory support was not less frequent in patients with advance directives.
Our study confirms others that found little evidence that advance directives affect life-sustaining treatments. (...)
Mots-clés Pascal : Relation médecin malade, Qualité service, Homme, Arrêt traitement, Qualité vie, Pratique professionnelle, Ethique, Evaluation, Questionnaire
Mots-clés Pascal anglais : Physician patient relation, Service quality, Human, Withdrawal, Quality of life, Professional practice, Ethics, Evaluation, Questionnaire
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0440682
Code Inist : 002B30A05. Création : 10/04/1997.