RT Journal Article
SR Electronic
T1 Communicating About Resuscitation: Problems And Prospects
JF The Journal of the American Board of Family
                Practice
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 137
OP 141
DO 10.3122/jabfm.6.2.137
VO 6
IS 2
A1 Ventres, William B.
YR 1993
UL http://www.jabfm.org/content/6/2/137.abstract
AB Background: The Patient Self-determination Act of 1991 implicitly encourages physicians to discuss advance directives and no-code orders with their patients. The medical literature to date, however, has done little to place resuscitative decision making in the context of how physicians, patients, and families communicate with one another. This paper investigates how interactions between involved parties affect the process and outcome of this decision making. Methods: Participant observation and open-ended interviews were conducted with patients, their families, resident physicians, and family medicine faculty members. Results: This report describes three social and cultural issues that commonly influence and shape the process of do-not-resuscitate decision making: judging competency and capacity, dealing with uncertainty, and recognizing attitudes toward death. Conclusions: Improved understanding of the communicative process can facilitate the establishment of meaningful, therapeutic alliances between physicians, patients, and families at an influential juncture in the family life cycle.