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Updated: Aug 15, 2026
14:32
Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
[Values anamnesis: a narrative approach to determining and interpreting advance directives]
1Klinik für Nephrologie, Medizinischen Fakultät der Otto-von-Guericke-Universität, Magdeburg, Deutschland.
Wiener Medizinische Wochenschrift (1946)
|January 1, 1997
Summary
Advance directives for medical care are widely supported but rarely used. Patients and healthcare professionals show reluctance in accepting these directives as authoritative guidance, especially in critical care situations.
Area of Science:
- Bioethics
- Medical Law
- Clinical Practice
Context:
- Advance directives for medical treatment and care are widely debated.
- Despite conceptual, clinical, ethical, and legal arguments favoring their use, patient execution remains low.
- Healthcare professionals exhibit reluctance in accepting advance medical directives.
Purpose:
- To explore the discrepancy between the acceptance of advance directives in principle and their practical application.
- To investigate the reasons behind the low execution rates of advance directives by patients.
- To understand the reluctance of physicians and nurses in adhering to advance directives during clinical decision-making.
Summary:
- While numerous arguments support advance directives, patient execution is infrequent.
- Physicians and nurses are hesitant to treat advance medical directives as binding in critical scenarios.
- This reluctance is particularly evident in cases involving dementia, terminal illness, or end-of-life care.
Impact:
- Highlights a significant gap in the implementation of patient-centered end-of-life care.
- Identifies barriers to the effective use of advance directives in clinical practice.
- Suggests a need for improved communication and training for healthcare providers regarding advance care planning.
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