“Hospital policies on life-sustaining treatments and advance directives in Canada” (1994) 150 Canadian Medical Association Journal 1265-70 (with I. Rasooly et al.).
This article determines the prevalence and content of hospital policies on life-sustaining treatments and advance directives in Canada, through a cross-sectional mailed survey. Although about half of the general public hospitals surveyed had DNR policies few had policies regarding other life-sustaining treatments or advance directives. Existing policies could be improved if hospitals encouraged routine advance discussions, removed the restriction to terminally or hopelessly ill patients, scrutinized the use of the futility standard, stipulated procedures for conflict resolution, explicitly required communication of the decision to competent patients or substitute decision-makers of incompetent patients and scrutinized the provision allowing families and health care professionals to rescind the wishes of now incompetent patients.