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dc.creatorMarkson, Lawrenceen
dc.creatorClark, Jacken
dc.creatorGlantz, Leonarden
dc.creatorLamberton, Victoriaen
dc.creatorKern, Donalden
dc.creatorStollerman, Geneen
dc.date.accessioned2015-05-05T19:02:23Zen
dc.date.available2015-05-05T19:02:23Zen
dc.date.created1997-04en
dc.date.issued1997-04en
dc.identifier10.1111/jgs.1997.45.issue-4en
dc.identifier.bibliographicCitationJournal of the American Geriatrics Society. 1997 Apr; 45(4): 399-406.en
dc.identifier.issn0002-8614en
dc.identifier.urihttp://worldcatlibraries.org/registry/gateway?version=1.0&url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&atitle=The+Doctor's+Role+in+Discussing+Advance+Preferences+for+End-of-Life+care:+Perceptions+of+Physicians+Practicing+in+the+Va&title=Journal+of+the+American+Geriatrics+Society.++&volume=45&issue=4&pages=399-406&date=1997&au=Markson,+Lawrenceen
dc.identifier.urihttp://dx.doi.org/10.1111/jgs.1997.45.issue-4en
dc.identifier.urihttp://hdl.handle.net/10822/753492en
dc.description.abstractOBJECTIVES: Although previous studies have shown physicians support advance directives, little is known about how they actually participate in decision-making. This study investigate (1) how much experience physicians have had discussing and following advance preferences and (2) how physicians perceive their role in the advance decision-making process. DESIGN: Mail survey conducted in 1993. SETTING: The Department of Veterans Affairs. PARTICIPANTS: A national probability sample of 1050 VA internists, family physicians, and generalists. MEASUREMENTS AND MAIN RESULTS: Questionnaires were returned by 67% of participants. In the last year, 79% stated they had discussed advance preference with at least one patient, and 19% had talked to more than 25. Seventy-three percent had used a written directive to make decisions for at least one incompetent patient. Younger age, board certification, spending less time in the outpatient setting, and personal experience with advance decision-making, were all associated independently with having advance preference discussions. Among physicians who had discussions, 59% said they often initiated the discussion, 55% said discussions often occurred in inpatient settings, and 31% said discussions often occurred in outpatient settings. Eighty-two percent of those responding thought physicians should be responsible for initiating discussions. Most would try to persuade a patient to change a decision that was not well informed (91%), not medically reasonable (88%), or not in the patient's best interest (88%); few would attempt to change decisions that conflicted with their own moral beliefs (14%). CONCLUSIONS: Physicians report that they are actively involved with their patients in making decisions about end-of-life care. Most say they have had recent discussions with at least some of their patients and feel that as physicians they should play a large and important role in soliciting and shaping patient preferences.en
dc.formatArticleen
dc.languageenen
dc.sourceBRL:MEDKIE/97255359en
dc.subjectAdvance Care Planningen
dc.subjectAdvance Directivesen
dc.subjectAge Factorsen
dc.subjectAttitudesen
dc.subjectCommunicationen
dc.subjectDecision Makingen
dc.subjectFederal Governmenten
dc.subjectGovernmenten
dc.subjectHealthen
dc.subjectHealth Careen
dc.subjectHospitalsen
dc.subjectIncentivesen
dc.subjectKnowledgeen
dc.subjectLifeen
dc.subjectMoral Obligationsen
dc.subjectPatientsen
dc.subjectPhysician's Roleen
dc.subjectPhysiciansen
dc.subjectPrimary Health Careen
dc.subjectProbabilityen
dc.subjectPublic Hospitalsen
dc.subjectQuestionnairesen
dc.subjectSurveyen
dc.subjectTerminal Careen
dc.titleThe Doctor's Role in Discussing Advance Preferences for End-of-Life Care: Perceptions of Physicians Practicing in the VAen
dc.provenanceDigital citation created by the National Reference Center for Bioethics Literature at Georgetown University for the BIOETHICSLINE database, part of the Kennedy Institute of Ethics' Bioethics Information Retrieval Project funded by the United States National Library of Medicine.en
dc.provenanceDigital citation migrated from OpenText LiveLink Discovery Server database named NBIO hosted by the Bioethics Research Library to the DSpace collection BioethicsLine hosted by Georgetown University.en


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