Clinical decision making and views about psychiatric advance directives

Psychiatric Services : a Journal of the American Psychiatric Association
Eric ElbogenAnna M Scheyett

Abstract

Psychiatric advance directives allow competent persons to document advance instructions or designate a health care agent to communicate their preferences for future mental health treatment in the event of an incapacitating crisis. Although laws authorizing psychiatric advance directives have proliferated, little is known about clinicians' understanding and perceptions of these legal tools. A total of 597 mental health professionals (psychiatrists, psychologists, and social workers) completed a survey about their attitudes toward psychiatric advance directives and decision making about following such directives. Approximately half the sample (47 percent) agreed that advance instructions would be helpful to consumers with severe mental illnesses, and a majority (57 percent) endorsed health care agents as beneficial. Regardless of profession, clinicians had more positive attitudes about psychiatric advance directives when they correctly recognized that they were not required by state law to follow directives that note the patient' s refusal of appropriate medical treatment. In multivariate analyses, the decision to abide by a patient' s advance refusal of treatment in a hypothetical scenario was predicted by knowing the laws assoc...Continue Reading

Citations

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