Deciding in the Dark: Advance Directives and Chronic Critical Illness
Posted Mar 03 2009 2:51pm
In the same week that Jane Brody (in New York) discusses the limitations of advance directives, a study " Deciding in the Dark: Advance Directives and Chronic Critical Illness," in the current Critical Care Medicine shows that because of New York's extremely restrictive laws on removing life support, advance directives are very important. "Most chronically critically ill patients fail to designate a surrogate decision-maker or express preferences regarding life-sustaining treatments. Despite burdensome symptoms and poor outcomes, limitation of such treatments was rare and occurred late, when patients were near death. Opportunities exist to improve communication and decision-making in chronic critical illness."