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Case for directives advanced.

Despite the article in CLINICAL PSYCHIATRY NEWS, there is a growing body of evidence that the presence of a durable power of attorney for health care, or advance directive, is in the best interest of optimal care ("Advance Directives May Undermine Good Care," June 2004, p. 92).

The Association of American Medical Colleges is in the process of investigating advance directives, and it is possible that their implementation might be added to the curricula of the 126 American medical schools.

The Joint Commission on Accreditation of Healthcare Organizations is evaluating the possibility of requiring all acute general hospitals to create registries of advance directives, and the University of California, San Francisco, will require all medical students beginning in September 2004 to fill out a personal advance directive.

The reason is very simple. An advance directive gives the patient and his or her loved ones control over the level of care being rendered in the last illness. In addition, such directives permit physicians to know exactly what the patient wishes in terms of the intensity of care.

Finally, medical decisions should be made by physicians and their patients, not by judges, as is the case with Terri Schiavo, the Florida woman who is in a vegetative state and is the subject of a tug of war between her husband, Michael Schiavo, and her parents.

If only an advanced directive had existed, this lurid battle in court would never have happened.

Michael J. Franzblau, M.D.

San Rafael, Calif.


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Title Annotation:LETTERS
Author:Franzblau, Michael J.
Publication:Clinical Psychiatry News
Article Type:Letter to the Editor
Date:Dec 1, 2004
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