Book: Everyday Humanism
Chapter: 11. On Thinking about an Advance Care Directive
In the United States, approximately half of all patients who die in the hospital are cared for in an ICU within three days of their death. Although how physicians approach decision-making when caring for critically ill patients is inadequately understood, the acknowledged reluctance of physicians to predict death, along with the complementary link between prognosis and therapy, adversely effect decision-making in patient care.Simply put, when given the ability to offer treatment even in “medically futile” cases, the majority of physicians will opt for end-stage therapy over comfort-only measures.The author explores the dilemna faced by many families trying to find their way through the process of choosing and implementing a legally binding advance care directive.