The living will: a national survey

Area of Science:

• Medical Ethics
• Health Policy
• Family Medicine

Background:

• Living wills are crucial legal documents for patient autonomy in healthcare decision-making.
• Physician understanding and utilization of living wills are vital for effective implementation.
• Informed consent processes increasingly incorporate advance care planning discussions.

Purpose of the Study:

• To assess the relationship between family physician knowledge of living wills and their clinical application.
• To examine how physician awareness of living wills influences discussions with patients.
• To explore the implications for integrating living wills into the informed consent process.

Main Methods:

• A national survey was conducted among 494 family physicians from the American Academy of Family Physicians.
• Data were collected from physicians across 39 jurisdictions with established living will statutes.
• Statistical analysis explored correlations between physician knowledge, usage, and discussion initiation.

Main Results:

• A significant positive correlation was found between physician knowledge of living wills and their actual clinical use.
• Physician awareness of living wills was positively associated with their readiness to initiate patient discussions about the document.
• Jurisdictional differences in statutes did not preclude observed knowledge-use relationships.

Conclusions:

• Enhancing physician knowledge of living wills is likely to increase their clinical utilization.
• Proactive physician engagement in discussing living wills can improve patient understanding and adherence to advance directives.
• Strengthening the role of living wills in informed consent requires focused physician education and support.