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[Advance directives in clinical practice].

J Vollmann1, I Knöchel-Schiffer

  • 1Lehrstuhl für Sozialmedizin, Sozialpsychiatrie und Medizinethik an der Evangelischen Fachhochschule Berlin. vollmann@ukbf.fu-berlin.de

Medizinische Klinik (Munich, Germany : 1983)
|August 7, 1999
PubMed
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Advance directives are underutilized in clinical practice despite patient and public support. Increased patient education on advance directives can enhance palliative care and respect end-of-life wishes.

Area of Science:

  • Medical Ethics
  • Health Law
  • Patient Autonomy

Context:

  • Advance directives (ADs) were developed in the US in the late 1960s to aid future medical decision-making for incapacitated patients.
  • Germany utilizes three primary forms of ADs: Patientenverfügungen, Betreuungsverfügungen, and Vorsorgevollmachten.
  • Empirical studies, predominantly from the US, have investigated the clinical implementation and stakeholder attitudes towards ADs.

Purpose:

  • To review empirical studies on the implementation and attitudes surrounding advance directives.
  • To analyze the gap between patient/public desire for AD use and actual clinical practice.
  • To highlight the potential of ADs in improving end-of-life care and respecting patient values.

Summary:

  • Despite strong patient and public support, advance directives are infrequently used in clinical settings.

Related Experiment Videos

  • Physicians tend to discuss treatment procedures more frequently than end-of-life decisions with patients.
  • Informing patients about advance directives presents an opportunity to improve palliative care and uphold patient autonomy.

    • Impact:

    • Enhanced patient and public awareness of advance directives can lead to greater utilization.
    • Improved communication regarding end-of-life decisions can align medical practice with patient preferences.
    • Respecting patient choices through advance directives contributes to more ethical and patient-centered end-of-life care.