Advance directives: Doctors and relatives often see patients' wishes differently

November 11, 2015

If a patient is no longer able to communicate personally how he or she would like to be treated, doctors and relatives consult an advance directive, if one is available. However, doctors and relatives often interpret patients' written wishes in different ways, as Nadja Leder et al. establish in their original article in the current issue of Deutsches Ärzteblatt International (Dtsch Arztbl Int 112: 723-9).

They conducted a study to investigate the advance directives of 50 nonresponsive intensive care patients: they used interviews and questionnaires to analyze how well treating physicians and patient representatives believed patients' written wishes were being or had been implemented. Doctors often judge advance directives to be unclearly worded and not applicable to the patient's current situation. For them, advance directives tend to serve as a guideline. Relatives, in contrast, try to implement patients' written wishes literally. They assigned a higher level of validity to advance directives than doctors did. Nevertheless, despite the differences in assessment, almost 70% of relatives stated that patients' wishes had been fully implemented. In the eyes of the authors, trusting dialogue between treating physicians and patient representatives results in high levels of satisfaction with treatment. Advance directives should be worded more appropriately, however, so that all those involved are of the same opinion regarding their validity.

Programs such as advanced care planning (ACP) may be suitable for this.

Deutsches Aerzteblatt International

Related Advance Directives Articles from Brightsurf:

Researchers advance fuel cell technology
Washington State University researchers have made a key advance in solid oxide fuel cells (SOFCs) that could make the highly energy-efficient and low-polluting technology a more viable alternative to gasoline combustion engines for powering cars.

New CRISPR advance may solve key quandary
A mutation unique to certain cancer tumors is a potential homing beacon for safely deploying CRISPR gene editing enzymes to disarm DNA that makes cancer cells resistant to treatment, while ignoring the gene in normal cells where it's critical to healthy function, according to to a new study from ChristianaCare's Gene Editing Institute in the journal Molecular Cancer Research.

Renewable energy advance
In order to identify materials that can improve storage technologies for fuel cells and batteries, you need to be able to visualize the actual three-dimensional structure of a particular material up close and in context.

Ocean acidification prediction now possible years in advance
CU Boulder researchers have developed a method that could enable scientists to accurately forecast ocean acidity up to five years in advance.

Researchers advance solar material production
A WSU team has developed a more efficient, safer, and cost-effective way to produce cadmium telluride (CdTe) material for solar cells or other applications, a discovery that could advance the solar industry and make it more competitive.

Chemists' calculations may advance cancer prediction
A computational study by Rice University chemists showed the dynamics of tumor formation don't necessarily correlate with clinical data on lifetime cancer risks.

SciLifeLab and AstraZeneca use cryo-EM to advance biomedicine
The receptor tyrosine kinase RET is a signalling complex of the enteric nervous system.

New computational method could advance precision medicine
Scientists have devised a new computational method that reveals genetic patterns in the massive jumble of individual cells in the body.

Advance in understanding of all-solid-state batteries
In a new paper published by Nature Materials entitled 'Critical Stripping Current Leads to Dendrite Formation on Plating in Lithium Anode Solid Electrolyte Cells,' Faraday Institution researchers at the University of Oxford have taken a step forward in understanding the mechanisms by which solid-state batteries fail -- a necessary prerequisite to avoiding such failures.

ADVANCE study provides evidence for shift to dolutegravir-containing ART in SA
The Wits Reproductive Health and HIV Institute and partners have presented evidence for a shift to dolutegravir-containing antiretroviral treatment in South Africa.

Read More: Advance Directives News and Advance Directives Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to