Patientenverfügung auf dem Prüfstand: Ärztliche Beratung ist unerlässlich

Schöffner, M.; Schmidt, Kurt W.; Benzenhöfer, Udo; Sahm, Stephan

doi:10.1055/s-0031-1298998

Cited by 18 publications

(5 citation statements)

References 3 publications

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“…71% of all patients who wished to get more information about the topic indicated that their family physician was their preferred source of information and 45% indicated their specialist (multiple responses were possible). Even though medical advice is not mandatory in Germany to write an AD, this survey confirms patients' need for advice [16]. In particular, the specialist physician who knows the patient's course and development of disease is best suited to address the topic and inform the patient.…”

Section: Discussionmentioning

confidence: 60%

Cancer Patients and Advance Directives: A Survey of Patients in a Hematology and Oncology Outpatient Clinic

Hubert¹,

Schulte²,

Belle³

et al. 2013

Oncol Res Treat

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Background: In 2009, Germany enacted a new law supporting advance directives that led to heated discussions in the media and the public. 3 years after the law passed, we surveyed patients with malignant diseases with regards to their views on advance directives. Patients and Methods: Between September 2011 and July 2012 an anonymous survey on advance directives was conducted among 617 patients at the hematology and oncology outpatient department of the University Hospital Mannheim, using a standardized questionnaire developed for this investigation. Results: Of the 503 patients who returned the questionnaire, 31% (n = 157) indicated having an advance directive. Of these 157, 54% (n = 85) completed the advance directive after 2009. 56% (282 out of 503) desired more information on advance directives. Of these, 71% (201 out of 282) wanted their general physician and 45% (128 out of 282) their specialist, to provide more information about this issue. Of the 339 patients without an advance directive, 47% (n = 158) stated that they had ‘not worried about that yet'. Conclusion: Although the percentage of patients with advance directives has increased since the legislative amendment, more information is still required by patients. It is recommended that physicians should discuss advance directives more frequently with their patients.

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Section: Discussionmentioning

confidence: 60%

Cancer Patients and Advance Directives: A Survey of Patients in a Hematology and Oncology Outpatient Clinic

Hubert¹,

Schulte²,

Belle³

et al. 2013

Oncol Res Treat

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“…For a non-medically trained person, creating a patient advance directive alone and without medical advice is difficult because of the unpredictable and medically complex developments that can occur in intensive care. A structured consultation is helpful for patients writing an advance directive, and is welcomed by patients (27,28).…”

Section: Discussionmentioning

confidence: 99%

Advance Directives and Powers of Attorney in Intensive Care Patients

Heer¹,

Saugel²,

Sensen³

et al. 2017

Deutsches Ärzteblatt International

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For patients hospitalized in intensive care units, there should be early discussion about the presence or absence of documents of these kinds and early evaluation of the patient's concrete wishes in critical situations. Future studies are needed to determine how best to assure that these documents will be correctly prepared and then given over to hospital staff so that they can take their place in the patient's record.

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“…Yet, younger people also benefit from guidance in drawing up ADs. Schöffner et al17 have shown the influence of a consultation over several hours on the contents and design of ADs. The German Advance Directive Act does not allow for any obligatory consultancy before drawing up such a will.…”

Section: Discussionmentioning

confidence: 99%

Intricate decision making: ambivalences and barriers when fulfilling an advance directive

Schröder¹,

Hommel²,

Sahm³

2016

PPA

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BackgroundDespite a recent statutory ruling stating the binding nature of advance directives (ADs), only a minority of the population has signed one. Yet, a majority deem it of utmost importance to ensure their wishes are followed through in case they are no longer able to decide. The reasons for this discrepancy have not yet been investigated sufficiently.Patients and methodsThis article is based on a survey of patients using a well-established structured questionnaire. First, patients were asked about their attitudes with respect to six therapeutic options at the end of life: intravenous fluids, artificial feeding, antibiotics, analgesia, chemotherapy/dialysis, and artificial ventilation; and second, they were asked about the negative effects related to the idea of ADs surveying their apprehensions: coercion to fulfill an AD, dictatorial reading of what had been laid down, and abuse of ADs.ResultsA total of 1,260 interviewees completed the questionnaires. A significant percentage of interviewees were indecisive with respect to therapeutic options, ranging from 25% (analgesia) to 45% (artificial feeding). There was no connection to health status. Apprehensions about unwanted effects of ADs were widespread, at 51%, 35%, and 43% for coercion, dictatorial reading, and abuse, respectively.ConclusionA significant percentage of interviewees were unable to anticipate decisions about treatment options at the end of life. Apprehensions about negative adverse effects of ADs are widespread.

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Patientenverfügung auf dem Prüfstand: Ärztliche Beratung ist unerlässlich

Cited by 18 publications

References 3 publications

Cancer Patients and Advance Directives: A Survey of Patients in a Hematology and Oncology Outpatient Clinic

Cancer Patients and Advance Directives: A Survey of Patients in a Hematology and Oncology Outpatient Clinic

Advance Directives and Powers of Attorney in Intensive Care Patients

Intricate decision making: ambivalences and barriers when fulfilling an advance directive

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