Overriding psychiatric advance directives: factors associated with psychiatrists' decisions to preempt patients' advance refusal of hospitalization and medication.
Journal Article (Journal Article)
Psychiatric advance directives (PADs) are intended to support patients' treatment decisions during a crisis. However, PAD statutes give clinicians broad discretion over whether to carry out patients' advance instructions. This study uses data from a survey of psychiatrists (N=164) to examine reasons for overriding PADs. In response to a hypothetical vignette, 47% of psychiatrists indicated that they would override a valid, competently-executed PAD that refused hospitalization and medication. PAD override was more likely among psychiatrists who worked in hospital emergency departments; those who were concerned about patients' violence risk and lack of insight; and those who were legally defensive. PAD override was less likely among participants who believed that involuntary treatment is largely unnecessary in a high-quality mental health system.
Full Text
Duke Authors
Cited Authors
- Swanson, JW; Van McCrary, S; Swartz, MS; Van Dorn, RA; Elbogen, EB
Published Date
- February 2007
Published In
Volume / Issue
- 31 / 1
Start / End Page
- 77 - 90
PubMed ID
- 16718578
International Standard Serial Number (ISSN)
- 0147-7307
Digital Object Identifier (DOI)
- 10.1007/s10979-006-9032-1
Language
- eng
Conference Location
- United States