Methods for advance medical planning were originally developedto ensure that patients' preferences would guide the natureand intensity of their future medical care. Increasingly, however,advance planning is viewed as a tool to limit care. For example,a study of the effects of advance directives on medical treatmentsand costs was performed, the authors said, with the "hope thatexecuting the California Durable Power of Attorney for HealthCare might provide a more ethical approach to reducing healthcare costs."1 Even when the purpose is not cost containment,there may be a philosophical emphasis on limiting, rather thanmaintaining, . . . [Full Text of this Article]
Address reprint requests to Dr. Levinsky at Boston University Medical Center, 88 E. Newton St., Boston, MA 02118.
References
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N Engl J Med 1997;
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