Doctors and relatives interpret a patient's written wishes in different ways, says a new study. When a patient is unable to communicate personally how they would like to be treated, doctors and relatives consult an advance directive, if one is available.
The researchers conducted a study to investigate the advance directives of 50 nonresponsive intensive care patients. They used interviews and questionnaires to analyze how well treating physicians and patient representatives believed patients' written wishes were being or had been implemented.
‘Advance directives allows a patient to convey their decisions about end-of-life care when they can no longer express themselves as a result of disease severity or treatment.
Doctors often judge advance directives to be unclearly worded and not applicable to the patient's current situation. For them, advance directives tend to serve as a guideline.
Relatives, in contrast, try to implement patients' written wishes literally. They assigned a higher level of validity to advance directives than doctors did. Nevertheless, despite the differences in assessment, almost 70% of relatives stated that patients' wishes had been fully implemented.
In the eyes of the authors, trusting dialogue between treating physicians and patient representatives results in high levels of satisfaction with treatment. Advance directives should be worded more appropriately, however, so that all those involved are of the same opinion regarding their validity.
The study has been published in Deutsches Ärzteblatt International.