98%
921
2 minutes
20
Efforts to promote the completion of advance directives implicitly assume that completion rates of these documents, which help ensure care consistent with people's preferences in the event of incapacity, are undesirably low. However, data regarding completion of advance directives in the United States are inconsistent and of variable quality. We systematically reviewed studies published in the period 2011-16 to determine the proportion of US adults with a completed living will, health care power of attorney, or both. Among the 795,909 people in the 150 studies we analyzed, 36.7 percent had completed an advance directive, including 29.3 percent with living wills. These proportions were similar across the years reviewed. Similar proportions of patients with chronic illnesses (38.2 percent) and healthy adults (32.7 percent) had completed advance directives. The findings provide benchmarks for gauging future policies and practices designed to motivate completion of advance directives, particularly among those people most likely to benefit from having these documents on record.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1377/hlthaff.2017.0175 | DOI Listing |
This manuscript explores the myriad ethical controversies associated with declaration of brain death/death by neurologic criteria (BD/DNC) during pregnancy raised by the case of Ms. Adriana Smith, a 30-year-old Georgia nurse, who came to international attention in May 2025. We will discuss: (1) the factors that may have impacted the decision not to perform neuroimaging when she first presented to medical attention; (2) the significance of identifying and deferring performance of futile interventions to decrease intracranial pressure relative to BD/DNC declaration; (3) the medical, ethical and legal complexities associated with BD/DNC declaration and continuation of maternal organ support in pregnancy; (4) the impact of continuing maternal organ support after BD/DNC declaration on the fetus, the family, Ms.
View Article and Find Full Text PDFBull Cancer
September 2025
Réanimation médicale et chirurgicale, groupe hospitalier Paris Saint-Joseph, 185, rue R.-Losserand, 75674 Paris, France; Research/Reflexion on End of life support Quality in Everyday Medical Practice (REQUIEM) Study Group, Paris, France. Electronic address:
Background: The prevalence of cancers and hematological malignancies is high and continues to grow. The severity of these pathologies calls for patients to be given the opportunity to express their values, particularly with regard to the intensity of treatment and the type of care they wish to receive. However, the prevalence of advance directives (ADs) in this population remains low.
View Article and Find Full Text PDFJMIR Res Protoc
September 2025
Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States.
Background: Cancer screening nonadherence persists among adults who are deaf, deafblind, and hard of hearing (DDBHH). These barriers span individual, clinician, and health care system levels, contributing to difficulties understanding cancer information, accessing screening services, and following treatment directives. Critical communication barriers include ineffective patient-physician communication, limited access to American Sign Language (ASL) cancer information, misconceptions about medical procedures, insurance navigation difficulties, and intersectional barriers for multiply marginalized individuals.
View Article and Find Full Text PDFAlzheimers Dement
September 2025
Multiomics Investigation of Neurodegenerative Diseases (MIND) Lab, Montréal, Québec, Canada.
Living with dementia requires decision making about numerous topics including daily activities and advance care planning (ACP). Both individuals living with dementia and care partners require informed support for decision making. We conducted an umbrella review to assess knowledge translation (KT) interventions supporting decision making for individuals living with dementia and their informal care partners.
View Article and Find Full Text PDFBMC Palliat Care
September 2025
Medical School, Internal Medicine Department, Geriatrics Division, São Paulo State University (UNESP), Av. Prof. Mario Rubens Guimaraes Montenegro, Botucatu, SN, 18618-687, Brazil.
Background/aims: The extent to which low- and middle-income countries have implemented Advance Care Planning (ACP) and Advance Directives (AD) remains unclear. We aimed to map the current status of ACP/AD in Latin America.
Methods: This cross-sectional, mixed-methods survey of ACP/AD in LA comprised interviews with 18 key informants from 18 out of 20 countries, most of whom were appointed by national Palliative Care Associations.