A Physician's Guide To Advance Medical Directives

From The Critics

Reviewer: Mark C. Mantooth, JD(Rush University Medical Center)
Description: This work explores the need for, bases, and background of advance medical directives, while addressing related topics and laws.
Purpose: The author expressly intends to assist physicians in fulfilling their "new" obligations under the Patient Self-Determination Act of 1990, which primarily requires health care facilities to ask patients on admission whether they have signed an advance directive and to at least minimally educate patients about their options concerning directives. Depending on the facilities' policies and procedures, physicians may need to explain to patients the various functions and effects of different advance directives. Inasmuch as the vast majority of patients do not have an adequate understanding of advance directives, the book provides overly general information and targets too narrow an audience.
Audience: The author directs the book to physicians, but any health care personnel dealing with patients, particularly admitting personnel, would benefit from the exposure to advance directives this book provides. Because the statutes that this work addresses are changing rapidly and the differences between jurisdictions vary widely, personnel should proceed cautiously when relying on the text.
Features: The references are current, but in many cases the author has failed to scrutinize the sources and accord them with their due import. The multilayered subdivisions of each chapter create a choppiness to the text and the failure to distinguish between jurisdictions may cause confusion. The most practical facet of this book lies in the appendixes, which provide brief summaries of pertinent court opinions as well as sample documents accompanied by explanations of how to execute them.
Assessment: Because of the increasing importance of advance directives in health care reform, the simple fact that this book addresses the topic and raises many of the relevant issues makes the work relatively valuable. The author, however, has chosen a scope far too broad to be explored adequately in this brief book and wholly overlooks much of the judicial philosophy and many of the ethical concerns underlying advance medical directives.

Mark C. Mantooth

This work explores the need for, bases, and background of advance medical directives, while addressing related topics and laws. The author expressly intends to assist physicians in fulfilling their "new" obligations under the Patient Self-Determination Act of 1990, which primarily requires health care facilities to ask patients on admission whether they have signed an advance directive and to at least minimally educate patients about their options concerning directives. Depending on the facilities' policies and procedures, physicians may need to explain to patients the various functions and effects of different advance directives. Inasmuch as the vast majority of patients do not have an adequate understanding of advance directives, the book provides overly general information and targets too narrow an audience. The author directs the book to physicians, but any health care personnel dealing with patients, particularly admitting personnel, would benefit from the exposure to advance directives this book provides. Because the statutes that this work addresses are changing rapidly and the differences between jurisdictions vary widely, personnel should proceed cautiously when relying on the text. The references are current, but in many cases the author has failed to scrutinize the sources and accord them with their due import. The multilayered subdivisions of each chapter create a choppiness to the text and the failure to distinguish between jurisdictions may cause confusion. The most practical facet of this book lies in the appendixes, which provide brief summaries of pertinent court opinions as well as sample documents accompanied by explanations of how to execute them. Because of theincreasing importance of advance directives in health care reform, the simple fact that this book addresses the topic and raises many of the relevant issues makes the work relatively valuable. The author, however, has chosen a scope far too broad to be explored adequately in this brief book and wholly overlooks much of the judicial philosophy and many of the ethical concerns underlying advance medical directives.

2 Stars from Doody