Jordan Potter, David S Reis, Jason Lesandrini, Eric Nelson
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引用次数: 0
Abstract
AbstractContext: As advance directives (ADs) become more frequently utilized, opportunities increase for conflict between a patient's designated healthcare power of attorney (POA) and the treatment preferences outlined in their living will (LW). Little is known about patient preferences regarding how to resolve these conflicts.
Objectives: To assess patient preferences regarding whether their POA or LW should have authority in times of conflict.
Methods: In this mixed methods study, we completed a retrospective chart review to analyze patient selections in their AD, including selections in a novel section of the AD called the "Binding Guidance" section that gives patients the ability to designate whether their POA or LW should have authority when there is conflict between the two. Additionally, willing patient participants were asked two interview questions about their selections to further elucidate their perspectives.
Results: Out of 143 patients, 48.3 percent (n = 69) chose to have their LW followed over their POA and 51.7 percent (n = 74) chose to have their POA followed over their LW. Several statistically significant associations were identified regarding binding guidance selections. Seventy-four (51.75%) of these patients also answered the additional interview questions, with the participants evenly distributed (n = 37 each) in their binding guidance selections.
Conclusion: Patients have varying preferences regarding whether their POA or LW should have authority in times of conflict. ADs should reflect this variation in preferences and allow patients the ability to designate whether they prefer their POA or LW to have ultimate authority when in conflict.
期刊介绍:
The Journal of Clinical Ethics is written for and by physicians, nurses, attorneys, clergy, ethicists, and others whose decisions directly affect patients. More than 70 percent of the articles are authored or co-authored by physicians. JCE is a double-blinded, peer-reviewed journal indexed in PubMed, Current Contents/Social & Behavioral Sciences, the Cumulative Index to Nursing & Allied Health Literature, and other indexes.