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Effect of patients' reasons for refusing treatment on implementing psychiatric advance directives.

Publication ,  Journal Article
Wilder, CM; Elbogen, EB; Swartz, MS; Swanson, JW; Van Dorn, RA
Published in: Psychiatr Serv
October 2007

OBJECTIVE: Clinicians have raised concerns that psychiatric advance directives may be used to refuse all treatment. However, people writing psychiatric advance directives can explicitly state their reasoning underlying treatment decisions. This study examined whether patients' reasons for refusing treatment influenced clinician decision making about implementing psychiatric advance directives. METHODS: A total of 597 mental health professionals completed a questionnaire that presented two scenarios: one in which the patient wrote a psychiatric advance directive refusing all medication because of paranoid delusions and one in which the patient wrote a psychiatric advance directive refusing all medication because of concerns about side effects. RESULTS: Twenty-two percent of clinicians reported that they would respect the former psychiatric advance directive, whereas 72% reported that they would respect the latter. After multivariate regression was used, the reason for treatment refusal remained the single significant predictor of clinicians' decision to honor a patient's psychiatric advance directive. CONCLUSIONS: Results show reasons for treatment refusal in psychiatric advance directives are likely to affect clinicians' decisions to implement the directives.

Duke Scholars

Published In

Psychiatr Serv

DOI

ISSN

1075-2730

Publication Date

October 2007

Volume

58

Issue

10

Start / End Page

1348 / 1350

Location

United States

Related Subject Headings

  • Treatment Refusal
  • Surveys and Questionnaires
  • Psychiatry
  • Patients
  • North Carolina
  • Middle Aged
  • Humans
  • Attitude of Health Personnel
  • Advance Directives
  • Adult
 

Citation

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Wilder, C. M., Elbogen, E. B., Swartz, M. S., Swanson, J. W., & Van Dorn, R. A. (2007). Effect of patients' reasons for refusing treatment on implementing psychiatric advance directives. Psychiatr Serv, 58(10), 1348–1350. https://doi.org/10.1176/ps.2007.58.10.1348
Wilder, Christine M., Eric B. Elbogen, Marvin S. Swartz, Jeffrey W. Swanson, and Richard A. Van Dorn. “Effect of patients' reasons for refusing treatment on implementing psychiatric advance directives.Psychiatr Serv 58, no. 10 (October 2007): 1348–50. https://doi.org/10.1176/ps.2007.58.10.1348.
Wilder CM, Elbogen EB, Swartz MS, Swanson JW, Van Dorn RA. Effect of patients' reasons for refusing treatment on implementing psychiatric advance directives. Psychiatr Serv. 2007 Oct;58(10):1348–50.
Wilder, Christine M., et al. “Effect of patients' reasons for refusing treatment on implementing psychiatric advance directives.Psychiatr Serv, vol. 58, no. 10, Oct. 2007, pp. 1348–50. Pubmed, doi:10.1176/ps.2007.58.10.1348.
Wilder CM, Elbogen EB, Swartz MS, Swanson JW, Van Dorn RA. Effect of patients' reasons for refusing treatment on implementing psychiatric advance directives. Psychiatr Serv. 2007 Oct;58(10):1348–1350.
Journal cover image

Published In

Psychiatr Serv

DOI

ISSN

1075-2730

Publication Date

October 2007

Volume

58

Issue

10

Start / End Page

1348 / 1350

Location

United States

Related Subject Headings

  • Treatment Refusal
  • Surveys and Questionnaires
  • Psychiatry
  • Patients
  • North Carolina
  • Middle Aged
  • Humans
  • Attitude of Health Personnel
  • Advance Directives
  • Adult