title: Challenges to implementation of advance directives of will in hospital practice.
abstract: to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context.
  qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles.
  the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication.
  limitations and difficulties in practice of advance directives of will from the perspective of the participants show, apart from countless conflicts and dilemmas regarding end-of life matters, that impending death experiences obstruct patients' wishes.
authors.affiliation: Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem. Rio Grande-RS, Brasil.
authors.forename: Silvana Bastos
authors.initials: SB
authors.lastname: Cogo
authors.affiliation: Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem. Rio Grande-RS, Brasil.
authors.forename: Valéria Lerch
authors.initials: VL
authors.lastname: Lunardi
authors.affiliation: Universidade Federal de Santa Maria, Programa de Pós-Graduação em Enfermagem. Santa Maria-RS, Brasil.
authors.forename: Alberto Manuel
authors.initials: AM
authors.lastname: Quintana
authors.affiliation: Universidade Federal de Santa Maria, Programa de Pós-Graduação em Enfermagem. Santa Maria-RS, Brasil.
authors.forename: Nara Marilene Oliveira
authors.initials: NM
authors.lastname: Girardon-Perlini
authors.affiliation: Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem. Rio Grande-RS, Brasil.
authors.forename: Rosemary Silva da
authors.initials: RS
authors.lastname: Silveira
mesh_terms: D000328:Adult; D016223:Advance Directives / Q000331:legislation & jurisprudence / Q000523:psychology*; D001293:Attitude to Death; D001938:Brazil; D005190:Family / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology