See this for why AMD are ultimately ignored:
physiciansnews.com
"Why Advance Directives Are Not Followed
A competent patient?s right to refuse life-sustaining medical treatment is fairly well established by both common law and legislative enactments. While Klavan may present a novel claim in Pennsylvania, patients in other jurisdictions have previously filed suit when their advance directives are ignored. These suits, plus many published research studies on this topic, demonstrate that doctors and health care providers often ignore the advance directives of their patients.
Various reasons have been postulated as to why advance directives are ignored, the most frequently cited os which is the fear of suit when a patient?s directives are opposed or disagreed with by family members. In these situations, fearing reprisals from family members, health care providers do not remove life-sustaining treatment unless mandated by a court order. Health care providers apparently adhere to the erroneous belief that they will be subject to a negligence or wrongful death action. This view prevails despite provisions in advance directive legislation, including Pennsylvania?s, that provide immunity to medical professionals who participate in the withdrawal of life sustaining treatment pursuant to an advanced directive."
In other words better make certain your family is all on the same page or you're SOL. I speak from experience on this one.
Some other urls:
hhdev.psu.edu
health.upenn.edu
see the section: Has the PSDA met its goals?
note this statistic: "Even the most recent studies find that no more than 31% or as little as 4% of the populations surveyed had completed the necessary documents (1). Although relatively few studies have been done to explain this phenomenon, there are several recurrent explenations."
see:
sciam.com
note: "Less than half of the physicians whose patients had signed orders forbidding cardiopulmonary resuscitation were aware of that fact. During the second phase of the study, each patient was assigned a nurse who had been trained to facilitate communication between patients, their families and physicians in order to make the patients' care more comfortable and dignified. The intervention failed dismally; the 2,652 patients who received this special attention fared no better, statistically speaking, than those in the control group or those in the previous phase of the investigation."
see:
aafp.org
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