Patient, physician, and family member understanding of living wills

Document Type

Article

Publication Title

American journal of respiratory and critical care medicine

Abstract

This study examines understanding of living wills by patients, family members, and physicians. Questionnaires were used to examine whether each cohort understood patients' living wills regarding endotracheal intubation and cardiopulmonary rescuscitation (CPR). Of 4,800 patients admitted during the study period, 206 reported having living wills, all of which precluded intubation and CPR for "terminal conditions." Of 140 admitted to the general hospital wards, 17 (12%) wanted their living wills to preclude intubation/mechanical ventilation and 12 (8.6%) did not want resuscitation under any circumstances. Seven of 120 (6%) physicians and 4 of 108 family members would not intubate or perform CPR even if there was a chance of recovery. Of 88 patients with complete data (including physicians and family members), 29 (33%) wanted their living wills to block intubation/mechanical ventilation only if they were deemed terminal and 46 (52%) wanted the living will to block intubation even if there was a 10% chance of recovery. Thirteen (15%) wanted to block intubation even if the chance of recovery was > or = 50. Results were similar for wishes regarding CPR. These data suggest substantial differences of patient, physician, and family member understanding of living wills. Living wills did not reflect fully patients' expectations of receiving (or not receiving) life-sustaining modalities.

First Page

1430

Last Page

5

DOI

10.1164/rccm.200206-503OC

Publication Date

12-1-2002

Identifier

12406822 (pubmed); 10.1164/rccm.200206-503OC (doi); 200206-503OC (pii)

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