Therapeutic jurisprudence and end-of-life medical care: physician perceptions of a statute's impact.
OBJECTIVE
Assess the perceptions of Ohio physicians regarding the impact of their state's 1990 advance directive legislation on their medical practices when decisions need to be made and implemented concerning use of life-prolonging medical interventions, and to draw public policy.


METHODS
A mailed survey to physicians, to be completed and returned anonymously. The form contained ten questions to be answered according to a five-point Likert scale, a request for demographic information, and an opportunity to write additional comments on the form.


METHODS
Surveys mailed to every physician on the Wright State University continuing medical education mailing list who had designated a specialty in internal medicine, family practice, or surgery.


METHODS
Physicians' perceptions of the impact of Ohio's advance directive legislation on their communication with patients and families, anxieties about legal liability associated with end-of-life care, and willingness to limit life-prolonging medical interventions in specific situations.


RESULTS
Mixed. While many physicians reported enhancements in relationships, communication, and willingness to respect patient and family wishes due to the statute, others reported an opposite effect. For many physicians, the statute made little impact on their practices.


CONCLUSIONS
The Ohio statute could benefit from rewriting, but there are inherent problems with advance directive laws. Professional education about death and dying issues and the chance for physicians to practice end-of-life treatment techniques are essential.
Kapp
M B
MB
Department of Community Health, Wright State University School of Medicine, USA.
D016223:Advance Directives / Q000331:legislation & jurisprudence*; D001291:Attitude of Health Personnel; D004992:Ethics, Medical; D006801:Humans; D016365:Liability, Legal; D009820:Ohio; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology