Journal of Medical Humanities

, Volume 18, Issue 3, pp 193-208

First online:

The Patient Self-Determination Act and Advance Directives: Snapshots of Activities in a Tertiary Health Care Center

  • John D. EngelAffiliated withNortheastern Ohio Universities College of Medicine
  • , Gregory KaneAffiliated withJefferson Medical College
  • , Deborah L. JonesAffiliated withAccreditation Council for Graduate Medical Education
  • , Debra Lynn-McHaleAffiliated withJefferson Medical College
  • , Martha SwartzAffiliated withJefferson Medical College
  • , Paul DurbinAffiliated withUniversity of Delaware
  • , Don KlingenAffiliated withJefferson Medical College

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This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs.