Five studies completed from 1992 through 1994 found that doctors incorporated only 5 to 25 percent of advance directives into treatment decisions for terminally ill patients. Yet without advance directives, physicians sometimes believe they have no choice but to attempt resuscitation of frail, even terminally ill patients. There has been progress. Gone are the days when doctors and families routinely withheld the diagnosis of terminal illness. Physicians say they are more willing to discontinue futile resuscitation efforts or bow to a patient's choice to forgo treatment.
Courts now recognize a person's right to refuse treatment.
For patients lacking advance directives, courts are sometimes willing to let families halt treatment. But interviews with health professionals, patients, families and experts in the field suggest that such efforts still often fall short - foiled by time pressures, social taboos, confusion and medical technology that's helped extend life.