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Practising what we preach: clinical ethicists’ professional perspectives and personal use of advance directives
  1. Jason Adam Wasserman1,
  2. Mark Christopher Navin2,
  3. Victoria Drzyzga3,
  4. Tyler S Gibb4
  1. 1Foundational Medical Studies and Pediatrics, Oakland University William Beaumont School of Medicine, Rochester, MI, United States
  2. 2Department of Philosophy, Oakland University, Rochester, MI, United States
  3. 3Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
  4. 4Program in Medical Ethics, Humanities and the Law, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
  1. Correspondence to Dr Jason Adam Wasserman, Foundational Medical Studies and Pediatrics, Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA; wasserman{at}oakland.edu

Abstract

The field of clinical bioethics strongly advocates for the use of advance directives to promote patient autonomy, particularly at the end of life. This paper reports a study of clinical bioethicists’ perceptions of the professional consensus about advance directives, as well as their personal advance care planning practices. We find that clinical bioethicists are often sceptical about the value of advance directives, and their personal choices about advance directives often deviate from what clinical ethicists acknowledge to be their profession’s recommendations. Moreover, our respondents identified a pluralistic set of justifications for completing treatment directives and designating surrogates, even while the consensus view focuses on patient autonomy. Our results suggest important revisions to academic discussion and public-facing advocacy about advance care planning.

  • end-of-life
  • living wills/advance directives
  • clinical ethics
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Footnotes

  • Contributors JAW conceptualised the study, conducted the analysis, drafted the initial manuscript, and reviewed and approved the final draft. MN conceptualised the study, conducted the analysis, revised the manuscript, and reviewed and approved the final draft. VD conducted portions of the analysis, revised the manuscript, and reviewed and approved the final draft. TSG conceptualised the study, revised the manuscript, and reviewed and approved the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This research was approved by the Oakland University Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request.

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