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<!DOCTYPE html> <html lang="en"> <head><script type='text/javascript' src='//cdnjs.cloudflare.com/ajax/libs/yui/3.6.0/yui/yui-min.js'></script><script type='text/javascript' src='//ajax.googleapis.com/ajax/libs/jquery/1.10.2/jquery.min.js'></script><script type='text/javascript' src='https://assets.adobedtm.com/4a848ae9611a/d0e96722185b/launch-d525bb0064d8.min.js'></script><script type='text/javascript' src=/assets/nr_browser_production.js></script>  <meta charset="utf-8"> <meta name="viewport" content="width=device-width"> <title> "An analysis of physicians' reluctance to follow terminally ill patient" by Norma Poirier </title>  <meta itemprop="name" content="An analysis of physicians' reluctance to follow terminally ill patients' advance directives"> <meta property="og:title" content="An analysis of physicians' reluctance to follow terminally ill patients' advance directives"> <meta name="twitter:title" content="An analysis of physicians' reluctance to follow terminally ill patients' advance directives"> <meta property="article:author" content="Norma Poirier"> <meta name="author" content="Norma Poirier"> <meta name="robots" content="noodp, noydir"> <meta name="description" content="This explanatory study examined the reasons why physicians have difficulty respecting the wishes of terminally ill patients who refuse treatment. Consistent with the relevant literature, three alternative explanations were hypothesized in answering the question: fear of litigation, religious beliefs, and medical professional values. Evidence was gathered from three different sources. Semistructured interviews were carried out with 24 emergency physicians from the Moncton Area in the Canadian province of New Brunswick and submitted to both quantitative and qualitative content analysis. Nineteen cases of terminally ill patients whose wishes not to be treated were not respected were collected and submitted to content analysis. Finally, administrative policies on resuscitative policies and on clinical ethics committees of all New Brunswick Hospital Corporations were collected and also submitted to content analysis. The results of the study showed that fear of litigation may be a partial explanation in about one third of the cases, but contradictory evidence also pointed to diverging conclusions. Religious beliefs may also account for certain physicians' attitudes toward refusal of treatment by their terminally ill patients. Statistically significant differences were found between unilingual and bilingual physicians. However, medical professional values were demonstrated to be the single most important factor in explaining why physicians acted the way they did in the treatment of their terminally ill patients. Normative pluralism and especially Luhmann's self-reference concept may explain why physicians had so much difficulty adapting their behaviors to meet the courts' legal decisions and the legislative changes respecting the rights of terminally ill patients who refuse treatment."> <meta itemprop="description" content="This explanatory study examined the reasons why physicians have difficulty respecting the wishes of terminally ill patients who refuse treatment. Consistent with the relevant literature, three alternative explanations were hypothesized in answering the question: fear of litigation, religious beliefs, and medical professional values. Evidence was gathered from three different sources. Semistructured interviews were carried out with 24 emergency physicians from the Moncton Area in the Canadian province of New Brunswick and submitted to both quantitative and qualitative content analysis. Nineteen cases of terminally ill patients whose wishes not to be treated were not respected were collected and submitted to content analysis. Finally, administrative policies on resuscitative policies and on clinical ethics committees of all New Brunswick Hospital Corporations were collected and also submitted to content analysis. The results of the study showed that fear of litigation may be a partial explanation in about one third of the cases, but contradictory evidence also pointed to diverging conclusions. Religious beliefs may also account for certain physicians' attitudes toward refusal of treatment by their terminally ill patients. Statistically significant differences were found between unilingual and bilingual physicians. However, medical professional values were demonstrated to be the single most important factor in explaining why physicians acted the way they did in the treatment of their terminally ill patients. Normative pluralism and especially Luhmann's self-reference concept may explain why physicians had so much difficulty adapting their behaviors to meet the courts' legal decisions and the legislative changes respecting the rights of terminally ill patients who refuse treatment."> <meta name="twitter:description" content="This explanatory study examined the reasons why physicians have difficulty respecting the wishes of terminally ill patients who refuse treatment. Consistent with the relevant literature, three alternative explanations were hypothesized in answering the question: fear of litigation, religious beliefs, and medical professional values. Evidence was gathered from three different sources. Semistructured interviews were carried out with 24 emergency physicians from the Moncton Area in the Canadian province of New Brunswick and submitted to both quantitative and qualitative content analysis. Nineteen cases of terminally ill patients whose wishes not to be treated were not respected were collected and submitted to content analysis. Finally, administrative policies on resuscitative policies and on clinical ethics committees of all New Brunswick Hospital Corporations were collected and also submitted to content analysis. The results of the study showed that fear of litigation may be a partial explanation in about one third of the cases, but contradictory evidence also pointed to diverging conclusions. Religious beliefs may also account for certain physicians' attitudes toward refusal of treatment by their terminally ill patients. Statistically significant differences were found between unilingual and bilingual physicians. However, medical professional values were demonstrated to be the single most important factor in explaining why physicians acted the way they did in the treatment of their terminally ill patients. Normative pluralism and especially Luhmann's self-reference concept may explain why physicians had so much difficulty adapting their behaviors to meet the courts' legal decisions and the legislative changes respecting the rights of terminally ill patients who refuse treatment."> <meta property="og:description" content="This explanatory study examined the reasons why physicians have difficulty respecting the wishes of terminally ill patients who refuse treatment. Consistent with the relevant literature, three alternative explanations were hypothesized in answering the question: fear of litigation, religious beliefs, and medical professional values. Evidence was gathered from three different sources. Semistructured interviews were carried out with 24 emergency physicians from the Moncton Area in the Canadian province of New Brunswick and submitted to both quantitative and qualitative content analysis. Nineteen cases of terminally ill patients whose wishes not to be treated were not respected were collected and submitted to content analysis. Finally, administrative policies on resuscitative policies and on clinical ethics committees of all New Brunswick Hospital Corporations were collected and also submitted to content analysis. The results of the study showed that fear of litigation may be a partial explanation in about one third of the cases, but contradictory evidence also pointed to diverging conclusions. Religious beliefs may also account for certain physicians' attitudes toward refusal of treatment by their terminally ill patients. Statistically significant differences were found between unilingual and bilingual physicians. However, medical professional values were demonstrated to be the single most important factor in explaining why physicians acted the way they did in the treatment of their terminally ill patients. Normative pluralism and especially Luhmann's self-reference concept may explain why physicians had so much difficulty adapting their behaviors to meet the courts' legal decisions and the legislative changes respecting the rights of terminally ill patients who refuse treatment."> <meta name="bepress_citation_dissertation_institution" content="Walden University"> <meta name="bepress_citation_dissertation_name" content="Ph.D."> <meta name="bepress_citation_author" content="Poirier, Norma"> <meta name="bepress_citation_title" content="An analysis of physicians' reluctance to follow terminally ill patients' advance directives"> <meta name="bepress_citation_date" content="1999">   <meta name="bepress_citation_pdf_url" content="https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=1006&context=hodgkinson"> <meta name="bepress_citation_abstract_html_url" content="https://scholarworks.waldenu.edu/hodgkinson/4"> <meta name="bepress_citation_online_date" content="2014/10/28"> <meta name="viewport" content="width=device-width">  <meta name="twitter:card" content="summary">  <meta property="og:type" content="article"> <meta property="og:url" content="https://scholarworks.waldenu.edu/hodgkinson/4"> <meta property="og:site_name" content="ScholarWorks">  <script type="text/javascript"> (function(e,t){var n=e.amplitude||{_q:[],_iq:{}};var r=t.createElement("script") ;r.type="text/javascript";r.async=true ;r.src="https://cdn.amplitude.com/libs/amplitude-4.5.2-min.gz.js" ;r.integrity="5ceGNbvkytO+PTI82JRl6GwJjVCw6k79kP4le5L5/m0Zny1P7taAF6YVvC4z4Pgj" ;r.onload=function(){if(e.amplitude.runQueuedFunctions){ e.amplitude.runQueuedFunctions()}else{ console.log("[Amplitude] Error: could not load SDK")}} ;var i=t.getElementsByTagName("script")[0];i.parentNode.insertBefore(r,i) ;function s(e,t){e.prototype[t]=function(){ this._q.push([t].concat(Array.prototype.slice.call(arguments,0)));return this}} var o=function(){this._q=[];return this} ;var a=["add","append","clearAll","prepend","set","setOnce","unset"] ;for(var u=0;u<a.length;u++){s(o,a[u])}n.Identify=o;var c=function(){this._q=[] ;return this} ;var l=["setProductId","setQuantity","setPrice","setRevenueType","setEventProperties"] ;for(var p=0;p<l.length;p++){s(c,l[p])}n.Revenue=c ;var d=["init","logEvent","logRevenue","setUserId","setUserProperties","setOptOut","setVersionName","setDomain","setDeviceId","setGlobalUserProperties","identify","clearUserProperties","setGroup","logRevenueV2","regenerateDeviceId","groupIdentify","logEventWithTimestamp","logEventWithGroups","setSessionId","resetSessionId"] ;function v(e){function t(t){e[t]=function(){ e._q.push([t].concat(Array.prototype.slice.call(arguments,0)))}} for(var n=0;n<d.length;n++){t(d[n])}}v(n);n.getInstance=function(e){ e=(!e||e.length===0?"$default_instance":e).toLowerCase() ;if(!n._iq.hasOwnProperty(e)){n._iq[e]={_q:[]};v(n._iq[e])}return n._iq[e]} ;e.amplitude=n})(window,document); 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Hodgkinson Award for Outstanding Dissertation</a></h2></div> <div style="clear: both"></div><div id="sub"> <div id="alpha"> <div id='title' class='element'> <h1><a href='https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=1006&context=hodgkinson'>An analysis of physicians' reluctance to follow terminally ill patients' advance directives</a></h1> </div> <div class='clear'></div> <div id='authors' class='element'> <h2 class='visually-hidden'>Author</h2> <p class="author"><a href='https://scholarworks.waldenu.edu/do/search/?q=author%3A%22Norma%20Poirier%22&start=0&context=2169507'><strong>Norma Poirier</strong></a><br /> </p></div> <div class='clear'></div> <div id='publication_date' class='element'> <h2 class='field-heading'>Date of Conferral</h2> <p>1999</p> </div> <div class='clear'></div> <div id='award_date' class='element'> <h2 class='field-heading'>Date of Award</h2> <p>2000</p> </div> <div class='clear'></div> <div id='degree_name' class='element'> <h2 class='field-heading'>Degree</h2> <p>Ph.D.</p> </div> <div class='clear'></div> <div id='department' class='element'> <h2 class='field-heading'>School</h2> <p>Public Health</p> </div> <div class='clear'></div> <div id='advisor1' class='element'> <h2 class='field-heading'>Advisor</h2> <p>Norma Poirier</p> </div> <div class='clear'></div> <div id='abstract' class='element'> <h2 class='field-heading'>Abstract</h2> <p>This explanatory study examined the reasons why physicians have difficulty respecting the wishes of terminally ill patients who refuse treatment. Consistent with the relevant literature, three alternative explanations were hypothesized in answering the question: fear of litigation, religious beliefs, and medical professional values.</p> <p>Evidence was gathered from three different sources. Semistructured interviews were carried out with 24 emergency physicians from the Moncton Area in the Canadian province of New Brunswick and submitted to both quantitative and qualitative content analysis. Nineteen cases of terminally ill patients whose wishes not to be treated were not respected were collected and submitted to content analysis. Finally, administrative policies on resuscitative policies and on clinical ethics committees of all New Brunswick Hospital Corporations were collected and also submitted to content analysis.</p> <p>The results of the study showed that fear of litigation may be a partial explanation in about one third of the cases, but contradictory evidence also pointed to diverging conclusions. Religious beliefs may also account for certain physicians' attitudes toward refusal of treatment by their terminally ill patients. Statistically significant differences were found between unilingual and bilingual physicians. However, medical professional values were demonstrated to be the single most important factor in explaining why physicians acted the way they did in the treatment of their terminally ill patients. Normative pluralism and especially Luhmann's self-reference concept may explain why physicians had so much difficulty adapting their behaviors to meet the courts' legal decisions and the legislative changes respecting the rights of terminally ill patients who refuse treatment.</p> </div> <div class='clear'></div> </div> </div> <div id='beta_7-3'>     <div class="aside download-button"> <a id="pdf" class="btn" href="https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=1006&context=hodgkinson" title="PDF (6.5 MB) opens in new window" target="_blank" > <i class="icon-download-alt" aria-hidden="true"></i> Download </a> </div>         <div id="article-stats" class="aside hidden"> <p class="article-downloads-wrapper hidden"><span id="article-downloads"></span> DOWNLOADS</p> <p class="article-stats-date hidden">Since October 28, 2014</p> </div>  <script type="text/javascript" src="/assets/scripts/article-downloads.pack.js"></script> <script type="text/javascript"> 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