Effectiveness of advance directives for the care of terminally ill patients in Chiang Mai University Hospital, Thailand

• Main Authors: Sittisombut S., Maxwell C., Love E.J., Sitthi-Amorn C.
• Format: Article
• Language: English
• Published: 2014
• Online Access: http://www.scopus.com/inward/record.url?eid=2-s2.0-38949170145&partnerID=40&md5=becab8b0c5637ff07af4b172d5563b70; http://www.ncbi.nlm.nih.gov/pubmed/18257830; http://cmuir.cmu.ac.th/handle/6653943832/4325
• Institution: Chiang Mai University

The key hypothesis behind advance directives (ADs) proposes that, if an intervention enhances a person's right to choose, a dying person will not opt for expensive, life-prolonging medical care and an ethically acceptable saving of resources will result. In order to assess the acceptability and effectiveness of ADs in reducing cardiopulmonary resuscitation (CPR) attempts and in-hospital death among terminally ill patients in a tertiary care hospital in northern Thailand, a non-randomized, controlled intervention study using an after-only unequivalent control group design was conducted. The majority of the subjects and the surrogates preferred to employ ADs in expressing their preferences on CPR and there was a high level of agreement between the subjects and surrogates on the decision. The use of ADs appeared to be effective in reducing futile CPR attempts and the in-hospital mortality rate among subjects during the index hospitalization. Advance directives were accepted well in this study setting. © 2008 The Authors Journal Compilation © 2008 Blackwell Publishing Asia Pty Ltd.