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November 27, 1995

On Advancing Advance Directives: Why Should We Believe the Promise?

Author Affiliations

Brigham and Women's Hospital Harvard Medical School 160 Commonwealth Ave Suite 801 Boston, MA 02116

Arch Intern Med. 1995;155(21):2271-2273. doi:10.1001/archinte.1995.00430210014002

In a recent issue of the Archives, Reilly et al1 undertook to determine whether a simple educational intervention, namely, the mailing of an educational brochure describing advance directives and a copy of the New York State Health Care Proxy form, would encourage outpatients in a community to execute durable health care proxies. In this editorial, the terms proxy and advance directive (AD) will be used interchangeably. Reilly et al reported no notable increase in completed proxies among those who had received the educational intervention (13.3%) and those who did not (11.4%). However, the authors indicated three important predictors of patient proxy completion-older age, previous in-hospital discussion of cardiopulmonary resuscitation (CPR) related to ADs with the physician, and execution of a proxy by the patient's personal physician. Neither severity of illness nor admission to an intensive care unit seemed to be related to the execution of a proxy. The most