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This version was published on September 1, 2007
American Journal of Hospice and Palliative Medicine®, Vol. 24, No. 4, 300-307 (2007)
DOI: 10.1177/1049909107302296

End-of-Life Decisions: Family Views on Advance Directives

Ellen W. Bernal, PhD, CIM

Ethics, St. Vincent Mercy Mecical Center, Toledo, Ellen_Bernal{at}mhsnr.org

Catherine A. Marco, MD, FACEP

Emergency Medicine, St. Vincent Mercy Mecical Center, Toledo, Department of Surgery, University of Toledo College of Medicine, Toledo

Sue Parkins, MD

Occupational Health Services St. Vincent Mercy Medical Center, Toledo

Nancy Buderer, MS, CIP

Biostatistician and Research Consultant, Oak Harbor

Sister Dorothy Thum, FACHE, RDLD, RSM

Mission and Values Integration and Mercy Health Partners, Toledo Ohio

A cross-sectional survey was administered to family members of patients who died at 1 of the 5 Catholic institutions comprising Mercy Health Partners, a health care system in Ohio, to determine their opinions about patient and family participation in decisions about end-of-life care. Among 165 respondents, 118 (86%) of 138 agreed that the family was encouraged to join in decisions and 133 (91%) of 146 that their family member's health care choices were followed. Most agreed that nurses answered their questions (93%, 141/151) and that the doctor communicated well with family members (83%, 128/155). Seventy percent (107/152) indicated that their family member had at least 1 advance directive. There were no differences in whether health care choices were followed when patients with formal advance directives (92%, 92/100) were compared with patients without formal advance directives (88%, 35/40). A unique survey instrument can be used to measure family perceptions and opinions of participation in decisions about end-of-life care.

Key Words: decisions • end of life • advance directives


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