Testing the Effectiveness of Advance Medical Directives;Final rept. for 1 Mar 95-28 Feg 02

摘要

The purpose of the research is to examine three key psychological assumptions underlying the effective use of advance medical directives in end-of-life decision making. Instructional advance directives are widely advocated as a crucial means of improving decision making at the end of life. Policy and law institutionalizing the use of advance directives, however, has not been supported by empirical research demonstrating their effectiveness and rests on psychological assumptions of questionable validity. This project was a 3 phase longitudinal study. Participants were 401 elderly adults and their self-designated surrogate decision makers. Phase 1 was a randomized controlled trial assessing the effectiveness of four advance directive interventions in improving the accuracy of surrogate substituted judgment. Phase 2 was a longitudinal study examining the stability of life-sustaining treatment preferences over time Phase 3 was a prospective study comparing life-sustaining treatment preferences over time. Phase 3 was a prospective study comparing life sustaining treatment preferences stated soon after a hospitalization experience to those state months before and after hospitalization.