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Are advance directives useful for doctors and what for?
In France, the law has introduced the possibility to write advance directives since 2005. In this paper, we will present the results of a study designed for checking how much people over 75 years are interested by this new tool. The inquiry consisted in deep qualitative interviews (around 45')...
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Published in: | La Presse médicale (1983) 2013-06, Vol.42 (6 Pt 1), p.e159-e169 |
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Main Authors: | , , , |
Format: | Article |
Language: | fre |
Subjects: | |
Online Access: | Get full text |
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Summary: | In France, the law has introduced the possibility to write advance directives since 2005. In this paper, we will present the results of a study designed for checking how much people over 75 years are interested by this new tool.
The inquiry consisted in deep qualitative interviews (around 45') to further understand what people included in the study have to say about advance directives, but also about the conditions of ageing and dying. The study sample was composed of 8 over 75 years subgroups, chosen for being illustrative of different health status and/or disabling status. Finally, a last subgroup was also included, called "referent", because composed of people, all members of the "Association pour le droit à mourir dans la dignité" (ADMD), and as such supposed to be pro-advance directives. Interviews content was analysed through qualitative analysis referent methods ("Analyse qualitative en sciences humaines et sociales", Paillé et Muschielli, "Grounded Theory", Glaser). POPULATION OF THE STUDY: One hundred and eighty-six patients were included (106 female, 80 male, mean age 82.7 ans), 167 in the general group and 19 in the "ADMD" group.
Ninety percent in the general group said that they never heard about advance directives before the inquiry. After having been informed by us about what advance directives were for, 83% remained not interested they said, some because they felt they were not personally concerned, others expressed that the tool appears to them inefficient - "things never happen the way you planned it", not useful - "doctors will act as they will decide whatever will be written", or even more potentially dangerous - "writing advance directives might lead doctors not to be as much therapeutically aggressive as for other people". Only 28 persons in the general group (17%), together with the 19 of the ADMD group, said they were interested by advance directives. They all were quite similar according to their personal character: they were quite strong and voluntary people, claiming firmly about their autonomy, independently of any sociodemographic profile. Furthermore, the interest for advance directives appears to be completely independent from the health or disabling status. Another important result of the study is that patients generally express themselves as being very confident and trustful in their doctors. They do not fear to be over-treated and having to support any futile treatment.
Around 20% of people are very much concerned by advanc |
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ISSN: | 2213-0276 |
DOI: | 10.1016/j.lpm.2012.09.027 |