• J D Orlander.
• Boston Veterans Affairs Medical Center, Evans Department of Medicine, Boston University School of Medicine, Mass 02130, USA.
• South. Med. J. 1999 May 1;92(5):481-4.

BackgroundAdvance directives (ADs) are advocated for many but executed by few. To ascertain the importance of education in the decision to execute an AD, I did this study to determine the rate at which health care workers (a medically educated group) and their families execute ADs.MethodsAll clinical staff at an urban tertiary care VA medical center were surveyed.ResultsOf 730 surveys mailed, 553 (76%) were returned, and 18% of respondents executed an AD. Age was the only variable that predicted execution of an AD. End-of-life medical decision-making discussions with family members were reported frequently (with spouses 74%, parents 50%).ConclusionHealth care workers do not appear to complete ADs at a rate any higher than the general population. Thus, education may be necessary, but alone it appears insufficient to increase use of ADs. Frequent family discussions occur among health care providers and their families. Such discussions may be an important outcome in their own right.

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