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Exploring Quality of Life in End-of-Life Discussions.

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Advance directives (ADs) legally document end-of-life (EOL) care preferences. Analysis of state statutes reveals limited inclusion of quality-of-life (QOL) language, impacting patient-centered care discussions.

Keywords:
advance care planningadvanced directivesend-of-lifeinterprofessional collaborative practicequality of lifethematic analysis

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Area of Science:

  • Health Law
  • Medical Ethics
  • Interprofessional Healthcare

Background:

  • Advance directives (ADs) are legal documents for end-of-life (EOL) medical treatment preferences.
  • They allow designation of a healthcare proxy before cognitive impairment.
  • Current statutes may inadequately address quality-of-life (QOL) considerations.

Purpose of the Study:

  • To explore the presence and nature of quality-of-life (QOL) language in US state advance directive (AD) statutes.
  • To identify gaps in statutory language concerning EOL care preferences.

Main Methods:

  • Exploratory study analyzing AD statutes from 50 US states and DC.
  • Constant comparative analysis for data coding.
  • Concepts grouped into communication/awareness and activities of daily living.

Main Results:

  • Communication/awareness language present in 50% of statutes.
  • Activities of daily living addressed in only 18% of statutes.
  • Only 3 states explicitly mentioned QOL.

Conclusions:

  • State statutes often lack comprehensive language regarding quality-of-life (QOL) in advance directives (ADs).
  • Interprofessional collaborative practice (IPCP) is crucial for person-centered EOL care discussions.
  • Enhancing statutory language can improve patient-centered EOL care planning.