11. On Thinking about an Advance Care Directive
Katrina Scott [+]
In the United States, approximately half of all patients who die in the hospital are cared for in an ICU within three days of their death. Although how physicians approach decision-making when caring for critically ill patients is inadequately understood, the acknowledged reluctance of physicians to predict death, along with the complementary link between prognosis and therapy, adversely effect decision-making in patient care.Simply put, when given the ability to offer treatment even in “medically futile” cases, the majority of physicians will opt for end-stage therapy over comfort-only measures.The author explores the dilemna faced by many families trying to find their way through the process of choosing and implementing a legally binding advance care directive.