Participating in end of life decisions. The role of general practitioners

'Advance directives' are instructions given by an individual regarding future health care decisions should they become incapacitated.

To explore the issues for GPs when introducing advance directives to their patients as a basis for further research into this process.

Interviews with GPs before and after the introduction of advance directives to patients during a normal consultation. General practitioners, from two medical practices in South Australia, were asked to record demographic details, time taken, patient's reaction and information requested.

Five GPs introduced advance directives to 26 patients. The average age was 77 years. Six of the 26 patients completed an advance directive. The main issues identified when introducing advance directives were the time factor and difficulty in advising patients about the kinds of medical treatment they might want to record in advance.

General practitioners require time and information if they are to assist patients in the process of completing an advance directive. Further research and extensive public education are necessary to develop relevant strategies to encourage the use of advance directives if they are to be utilised to assist people to face death with some sense of control.