Comparison of CMA Joint Statement on Resuscitative Interventions and New Brunswick hospital corporations' policies on end-of-life treatments

Why do most physicians have so much difficulty respecting the wishes of the ir terminally ill patients who refuse treatment? The normative pluralism mo del is introduced to answer this question. Comparative content analysis ser ves as the theoretical framework for evaluating the Canadian Medical Associ ation Joint Statement on Resuscitative Interventions against the correspond ing administrative policies of New Brunswick hospital corporations and rele vant New Brunswick law. Despite protection afforded patients by law, fully 75% of New Brunswick hospital corporations' administrative policies permit physicians to ignore patients' expressed objection to treatments. The futil ity-of-treatment criteria in the CMA joint statement and in all provincial hospital corporations' policies authorize physicians to substitute their ju dgment for patients' expressed refusal of CPR. The author concludes that wh en medical professional norms conflict with the law, physicians tend to fol low their professional normative order.