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At least 181 records · Page 10Linked to original sources
PubMed1994

Elderly outpatients' understanding of a physician-initiated advance directive discussion.

OBJECTIVE: To examine elderly outpatients' understanding of advance directives (ADs), cardiopulmonary resuscitation (CPR), and artificial nutrition and hydration (ANH) with and without the benefit of a physician-initiated discussion. DESIGN: Randomized controlled trial. SETTING: University-affiliated, community-based, urban family practice residency training program. PATIENTS: One hundred patients aged 65 and older, consecutively sampled and randomly assigned to one of two discussion groups. INTERVENTIONS: Physicians' discussions based on a prepared script consisting of AD issues or health promotion issues. MAIN OUTCOME MEASURES: Test of comprehension of AD, CPR, and ANH information, using open-ended and yes-or-no questions. RESULTS: Patients in the AD and health promotion discussion groups showed good basic understanding. Younger and better-educated patients had a better working knowledge of AD-related information. Understanding of ADs was higher when the physician spent more time talking about AD-related issues after the discussion was completed. CONCLUSIONS: Many elderly outpatients have a good basic understanding of ADs, CPR, and ANH, even without explicit explanations from physicians. However, younger, better-educated patients and those who had longer unstructured discussions had greater AD-related knowledge. These factors need to be considered when framing discussions with patients about ADs and life-sustaining treatments.

Advance Directives↗
PubMed1997

Feminist theory confronts US Supreme Court rhetoric: the case of abortion rights.

The research presented below analyses the rhetoric of abortion jurisprudence from the perspective of fundamental principles of feminist theory. While focused primarily on the American experience, it addresses and raises questions that are on the political agenda in a significant number of contemporary societies. The feminist principles identified, and against which judicial rhetoric is assessed, include: the importance of actual life experience over abstract principles, the significance of the distinction between the public and private realms and the understanding of society as a web of relationships. Demonstrated by the relevant data is that the decisions of the judiciary restrictive of reproductive choice are characterized by a distinctly non-feminist rhetoric.

Abortion, Legal↗
PubMed1988

Life prolongation: views of elderly outpatients and health care professionals.

A peculiar dynamic in communication exists between those who are most likely to be involved in life-prolongation decisions. We found that both the elderly and health care professionals talk about life-prolongation, but not with one another; that they consider some of the same factors as they think about the life-prolongation decision; and that most of them believe physicians should be responsible for initiating discussion. However, the physician or health care professional who wishes to avoid crisis situations also is reluctant to broach the issue for fear of unnecessarily alarming or compromising the defense mechanisms of the patient. The patient remains patient, waiting--with fears of dependency, memories of previous life-threatening experiences, and deep sensitivity for suffering--for the physician to initiate the discussion. Is a mediator such as a family member necessary in these situations? Is the hospital environment not conductive to discussion of less than heroic efforts?

Age Factors↗