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Greco PJ, Schulman KA, Lavizzo-Mourey R, Hansen-Flaschen J: The Patient Self-Determination Act and the future of advance directives. Ann Intern Med 1991, 115:639-643.
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0028932049
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Implementation of the Patient Self-Determination Act in a hospital setting: An initial evaluation
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Silverman HJ, Tuma P, Schaeffer MH, Singh B: Implementation of the Patient Self-Determination Act in a hospital setting: an initial evaluation. Arch Intern Med 1995, 155:502-510. A prospective observational study at a single university hospital that examined the effectiveness of their program of informing patients about advanced directives and the patient-related variables related to the success of this process (race and educational level were found to be independent predictors).
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Arch Intern Med
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Silverman, H.J.1
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Perkins HS: Are advance directives becoming an endangered species? Chest 1996, 109:299.
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Perkins, H.S.1
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0028881086
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On advancing advance directives: Why should we believe the promise?
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McIntyre KM: On advancing advance directives: why should we believe the promise? Arch Intern Med 1995, 155:2271-2273.
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Arch Intern Med
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Discussions with outpatients with chronic obstructive pulmonary disease regarding mechanical ventilation as life-sustaining therapy
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Travaline JM, Silverman HJ: Discussions with outpatients with chronic obstructive pulmonary disease regarding mechanical ventilation as life-sustaining therapy. South Med J 1995, 88:1034-1038.
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Talking, advance directives, and medical practice
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Loewy EH, Carlson RW: Talking, advance directives, and medical practice. Arch Intern Med 1994, 154:2265-2267.
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Loewy, E.H.1
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Physician reluctance to discuss advance directives: An empiric investigation of potential barriers
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Morrison RS, Morrison EW, Glickman DF: Physician reluctance to discuss advance directives: an empiric investigation of potential barriers. Arch Intern Med 1994, 154:2311-2318.
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Morrison, R.S.1
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8
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0028803075
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Promoting inpatient directives about life-sustaining treatments in a community hospital: Results of a 3 year time-series intervention trial
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Reilly BM, Wagner M, Magnussen R, Ross J, Papa L, Ash J: Promoting inpatient directives about life-sustaining treatments in a community hospital: results of a 3 year time-series intervention trial. Arch Intern Med 1995, 155:2317-2323.
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9
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Living wills and resuscitation preferences in elderly population
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Walker RM, Schonwetter RS, Kramer DR, Robinson BE: Living wills and resuscitation preferences in elderly population. Arch Intern Med 1995, 155:171-175.
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Arch Intern Med
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Walker, R.M.1
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0028887929
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Use of the medical futility rationale in do-not-attempt-resuscitation orders
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Curtis JR, Park DR, Krone MR, Pearlman RA: Use of the medical futility rationale in do-not-attempt-resuscitation orders. JAMA 1995, 273:124-128. A cross-sectional study of self-reported attitudes and practices of medical residents at two university affiliated hospitals that found that residents' conceptions of what is futile to justify use of DNR orders varied widely both in terms of quantitative and qualitative futility. They found residents equated futility with a probability of dying during hospitalization that ranged from 0% to 75%.
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JAMA
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Curtis, J.R.1
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11
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The inaccessibility of advance directives on transfer from ambulatory to acute care settings
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Morrison RS, Olson E, Mertz KR, Meier DE: The inaccessibility of advance directives on transfer from ambulatory to acute care settings. JAMA 1995, 274:478-482.
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Morrison, R.S.1
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12
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0028870650
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Decisions to limit or continue life-sustaining treatment by critical care physicians in the United States: Conflicts between physician's practices and patient's wishes
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Asch DA, Hansen-Flaschen J, Lanken PN: Decisions to limit or continue life-sustaining treatment by critical care physicians in the United States: conflicts between physician's practices and patient's wishes. Am J Respir Crit Care Med 1995, 151:288-292. A cross-sectional survey of critical care physicians' self-reported behavior related to withholding and withdrawing life-support. Despite a very high overall prevalence of withholding and withdrawing life-support, a substantial fraction of the respondents reported that they refused to carry out such requests by family or patients. A large fraction of respondents also incorporated some aspect of medical futility in their decision making process in some cases.
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Am J Respir Crit Care Med
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Asch, D.A.1
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Capron AM: In re Helga Wanglie. Hastings Cent Rep 1991, 21:30-35.
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Engelhardt HT, Khushf G: Futile care for the critically ill patient. Curr Opin Crit Care 1995, 1:329-333. An essay about the usage of the term "futility" when applied to medical intervention. Its inherent ambiguities can explain the inconsistencies in interpretation observed in empirical studies.
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Curr Opin Crit Care
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Engelhardt, H.T.1
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18
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Futility and hospital policy
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Tomlinson T, Czlonka D: Futility and hospital policy. Hastings Cent Rep 1995, 25:28-35. An essay on how to operationalize the use of medical futitlity within the context of hospital policies; it provides a model policy in this regard.
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Hastings Cent Rep
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Tomlinson, T.1
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The cardiopulmonary resuscitation-not-indicated order: Futility revisited
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Waisel DB, Truog RD: The cardiopulmonary resuscitation-not-indicated order: futility revisited. Ann Intern Med 1995, 122:304-308.
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Capron AM: Abandoning a waning life. Hastings Cent Rep 1995, 25:24-26.
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The SUPPORT Principal Investigators: A controlled trial to improve care for seriously ill hospitalized patients: the study to understand prognoses and preferences for outcomes and risks of treatment (SUPPORT). JAMA 1995, 274:1591-1636. A prospective observational study followed by an interventional clinical trial to improve physician-patient communication and decision making related to end-of-life medical care at five US teaching hospitals. The intervention included objective prognostic estimates of hospital survival and functional status after CPR and the efforts of a full-time trial nurse to inform patients and encourage communications about preferences related to end-of-life medical care. No significant differences were observed in the interventional group versus the control group.
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Dubler NN: The doctor-proxy relationship: the neglected connection. Kennedy Inst Ethics J 1995, 5:289-306. This comprehensive essay focuses in on the poorly defined relationship between health care proxies and physicians, especially a physician's ethical duties to proxies, and identifies problems with this relationship as a major contributor to lack of success of advanced directives.
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J Clin Ethics
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J Clin Ethics
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Christakis NA, Asch DA: Physician characteristics associated with decisions to withdraw life support. Am J Public Health 1995, 85:367-372. Results of a survey of Pennsylvania internists indicated that the respondents' personal characteristics, such as age and religion, and professional characteristics, such as medical specialty and exposure to ICU patients, influenced the respondents' willingness to withdraw life-support and their self-reported behavior in this regard.
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Am J Public Health
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Annas GJ: How we lie. Hastings Cent Rep 1995, 25:S12-S14. An essay that argues for the establishment of proactive legal measures to ensure that patient preferences regarding life-support are respected more consistently by the medical profession.
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Schneider CE: From consumer choice to consumer welfare. Hastings Cent Report 1995, 25:S25-S28. The author suggests that the movement to empower patients by giving them more information about advance directives may be inadequate in a medical bureaucracy like a hospital and that more proactive reforms such as exist in the consumer welfare movement might be more useful. Doing more of the same, he suggests, is not likely to work.
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