0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

The Illusion of Patient Choice in End-of-Life Decisions

David Orentlicher, MD, JD
JAMA. 1992;267(15):2101-2104. doi:10.1001/jama.1992.03480150107047.
Text Size: A A A
Published online

Extract

President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Deciding to Forego Life-Sustaining Treatment: Ethical, Medical, and Legal Issues in Treatment Decisions . Washington, DC: US Government Printing Office; 1983:43.
Guidelines on the Termination of Life-Sustaining Treatment and the Care of the Dying . Briarcliff Manor, NY: The Hastings Center; 1987:26-28.
Council on Ethical and Judicial Affairs. Current Opinions: 1992 . Chicago, Ill: American Medical Association; 1992:§2.20.
Cruzan v Director, Missouri Department of Health, 110 S Ct 2841 (1990).
Danis M, Southerland LI, Garrett JM, et al.  A prospective study of advance directives for life-sustaining care. N Engl J Med . 1991;324:882-888.
Link to Article[[XSLOpenURL/10.1056/NEJM199103283241304]]
Emanuel LL, Barry MJ, Stoeckle JD, Ettelson LM, Emanuel EJ.  Advance directives for medical care: a case for greater use. N Engl J Med . 1991;324:889-895.
Link to Article[[XSLOpenURL/10.1056/NEJM199103283241305]]
Wachter EM, Luce JM, Hearst N, Lo B.  Decisions about resuscitation: inequities among patients with different diseases but similar prognoses. Ann Intern Med . 1989;111:525-532.
Link to Article[[XSLOpenURL/10.7326/0003-4819-111-6-525]]
Smedira NG, Evans BH, Grais LS, et al.  Withholding and withdrawal of life support from the critically ill. N Engl J Med . 1990;322:309-315.
Link to Article[[XSLOpenURL/10.1056/NEJM199002013220506]]
McNeil BJ, Weichselbaum R, Pauker SG.  Fallacy of the 5-year survival in lung cancer. N Engl J Med . 1978;299:1397-1401.
Link to Article[[XSLOpenURL/10.1056/NEJM197812212992506]]
Goyert GL, Bottoms SF, Treadwell MC, Nehra PC.  The physician factor in cesarean birth rates. N Engl J Med . 1989;320:706-709.
Link to Article[[XSLOpenURL/10.1056/NEJM198903163201106]]
 Council on Ethical and Judicial Affairs, American Medical Association. Blackwhite disparities in health care. JAMA . 1990;263:2344-2346.
Link to Article[[XSLOpenURL/10.1001/jama.1990.03440170066038]]
Wenneker MB, Epstein AM.  Racial inequalities in the use of procedures for patients with ischemic heart disease in Massachusetts. JAMA . 1989;261:253-257.
Link to Article[[XSLOpenURL/10.1001/jama.1989.03420020107039]]
Held PJ, Pauly MV, Bovbjerg RR, Newmann J, Salvatierra O.  Access to kidney transplantation: has the United States eliminated income and racial differences? Arch Intern Med . 1988;148:2594-2600.
Link to Article[[XSLOpenURL/10.1001/archinte.1988.00380120056011]]
Council on Ethical and Judicial Affairs, American Medical Association.  Guidelines for the appropriate use of do-not-resuscitate orders. JAMA . 1991;265:1868-1871.
Link to Article[[XSLOpenURL/10.1001/jama.1991.03460140096034]]
Bedell SE, Pelle D, Maher PL, Cleary PD.  Do-not-resuscitate orders for critically ill patients in the hospital: how are they used and what is their impact? JAMA . 1986;256:233-237.
Link to Article[[XSLOpenURL/10.1001/jama.1986.03380020095030]]
Evans AL, Brody BA.  The do-not-resuscitate order in teaching hospitals. JAMA . 1985;253:2236-2239.
Link to Article[[XSLOpenURL/10.1001/jama.1985.03350390078029]]
Seckler AB, Meier DE, Mulvihill M, Cammer Paris BE.  Substituted judgment: how accurate are proxy predictions? Ann Intern Med . 1991;115:92-98.
Link to Article[[XSLOpenURL/10.7326/0003-4819-115-2-92]]
President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Making Health Care Decisions . Washington, DC: US Government Printing Office; 1982;1.
Wallace LM.  Informed consent to elective surgery: the 'therapeutic value?' Soc Sci Med . 1986;22:29-35.
Link to Article[[XSLOpenURL/10.1016/0277-9536(86)90305-9]]
Davidson KW, Hackler C, Caradine DR, McCord RS.  Physicians' attitudes on advance directives. JAMA . 1989;262:2415-2419.
Link to Article[[XSLOpenURL/10.1001/jama.1989.03430170077032]]
Levy DR.  White doctors and black patients: influence of race on the doctor-patient relationship. Pediatrics . 1985;75:639-643.
Waitzkin H.  Doctor-patient communication: clinical implications of social scientific research. JAMA . 1984;252:2441-2446.
Link to Article[[XSLOpenURL/10.1001/jama.1984.03350170043017]]
Marteau TM.  Framing of information: its influence upon decisions of doctors and patients. Br J Soc Psychol . 1989;28:89-94.
Link to Article[[XSLOpenURL/10.1111/bjso.1989.28.issue-1]]
Malloy TR, Wigton RS, Meeske J, Tape TG. How interventions are described affects patients' decisions about life sustaining treatment. In: Program of the American Geriatric Society/American Federation for Aging Research Annual Scientific Meeting. 1991. Abstract A2.
Ende J, Kazis L, Ash A, Moskowitz MA.  Measuring patients' desire for autonomy: decision making and information-seeking preferences among medical patients. J Gen Intern Med . 1989;4:23-30.
Link to Article[[XSLOpenURL/10.1007/BF02596485]]
Sehgal A, Galbraith A, Chesney M, Schoenfeld P, Charles G, Lo B.  How strictly do dialysis patients want their advance directives followed? JAMA . 1992;267:59-63.
Link to Article[[XSLOpenURL/10.1001/jama.1992.03480010067026]]
Tomlinson T, Brody H.  Futility and the ethics of resuscitation. JAMA . 1990;264:1276-1280.
Link to Article[[XSLOpenURL/10.1001/jama.1990.03450100066027]]
Kodish E, Lantos J, Stocking C, Singer PA, Siegler M, Johnson FL.  Bone marrow transplantation for sickle cell disease: a study of parents' decisions. N Engl J Med . 1991;325:1349-1353.
Link to Article[[XSLOpenURL/10.1056/NEJM199111073251905]]
Callahan D.  On feeding the dying. Hastings Cent Rep . 1983;20:22.
In re Bowman, 617 P2d 731 (Wash, 1980).
Dority v Superior Court, 145 Cal App 3d 273,193 Cal Rptr 288 (Cal Ct App, 1983).
In re Quinlan, 70 NJ 10, 355 A2d 647 (1976).
Miles SH.  Informed demand for 'non-beneficial' medical treatment. N Engl J Med . 1991;325:512-515.
Link to Article[[XSLOpenURL/10.1056/NEJM199108153250713]]
Youngner SJ, Bartlett ET.  Human death and high technology: the failure of the whole-brain formulations. Ann Intern Med . 1983;99:252-258.
Link to Article[[XSLOpenURL/10.7326/0003-4819-99-2-252]]
Katz J. The Silent World of Doctor and Patient . New York, NY: The Free Press; 1984:48-84.
Louisell DW, Williams H. Medical Malpractice . New York, NY: Matthew Bender; 1989.
Localio AR, Lawthers AG, Brennan TA, et al.  Relation between malpractice claims and adverse events due to negligence: results of the Harvard Medical Practice Study III. N Engl J Med . 1991;325:245-251.
Link to Article[[XSLOpenURL/10.1056/NEJM199107253250405]]
Uhlmann RF, Pearlman RA, Cain KC.  Physicians' and spouses' predictions of elderly patients' resuscitation preferences. J Gerontol . 1988;43:M115-M121.
Link to Article[[XSLOpenURL/10.1093/geronj/43.5.M115]]
42 USC §§ 1395cc(f), 1396a(w).
La Puma J, Orentlicher D, Moss RJ.  Advance directives on admission: clinical implications and analysis of the Patient Self-determination Act of 1990. JAMA . 1990;266:402-405.
Link to Article[[XSLOpenURL/10.1001/jama.1991.03470030102032]]

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

Letters

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();