title: Determining the relationship between end-of-life decisions expressed in advance directives and resuscitation efforts during cardiopulmonary resuscitation.
abstract: In recent years, there has been an increased focus on end-of-life decisions and the use of medical technology. It is not well documented in the literature whether or not and to what extent patients' advance directives are used for directing resuscitative efforts. The purpose of this study was to determine how useful patients' advance directives were to members of the health care team in determining treatment and end-of-life decisions among patients who received cardiopulmonary resuscitation (CPR) efforts. Medical records of 135 adult patients who had undergone CPR efforts within the previous year were reviewed to determine if and to what extent advance directives were useful in directing end-of-life care and treatment decisions. Only 35 of these patients had advance directives. Three categories for advance directives emerged: those that were "independently directive," those that were "vague and required further clarification," and those that were "nondirective." Information from this study may be used to clarify treatment options for end-of-life care and to determine if and what further interventions are required to ensure that advance directives can be executed as meaningful documents.
authors.affiliation: Shands Hospital, University of Florida, Gainesville, Florida, USA.
authors.forename: M
authors.initials: M
authors.lastname: Gilbert
authors.forename: C M
authors.initials: CM
authors.lastname: Counsell
authors.forename: P
authors.initials: P
authors.lastname: Guin
authors.forename: R
authors.initials: R
authors.lastname: O'Neill
authors.forename: S
authors.initials: S
authors.lastname: Briggs
mesh_terms: D024362:Advance Directive Adherence; D016223:Advance Directives; D000368:Aged; D016887:Cardiopulmonary Resuscitation; D003657:Decision Making; D006801:Humans; D008875:Middle Aged; D010348:Patient Care Team; D012189:Retrospective Studies; D013727:Terminal Care