Objectives-To study the value of taking an ethics history as a means of ass
essing patients' preferences for decision making and for their relatives' i
nvolvement.
Design-Questionnaire administered by six junior doctors to 56 mentally comp
etent patients, admitted into general and geriatric medical beds.
Setting-A large district general hospital in the United Kingdom.
Main measures-To establish whether patients were adequately informed about
their illness and whether they minded the information being communicated to
their relatives. To establish their preference regarding truthful disclosu
re and participation in derision making with risk attached. To establish wh
ether they wished to be involved in CPR decision making, and if not, who sh
ould make the decision. To establish whether they knew of living wills and
whether they had any advance directives.
Results-Twenty-four (43%) were inadequately informed of their illness. Fort
y-six (82%) said they would want to know were something serious to be found
. Twenty-eight (50%) wanted to make their own decision if requiring risky t
reatment and 11 (20%) wanted family members involved. Thirty-one (55%) want
ed to make a cardiopulmonary resuscitation (CPR) decision and five of these
decisions differed from those made by the doctors. Twenty-Jive (45%) prefe
rred the doctors to decide. Eleven (20% of the patients had heard of living
wills but only one had executed such a will. Seven (13%) of the patients w
ished to provide advance directives. Three (5%) did not find the history ta
king helpful but none were discomforted.
Conclusion-Taking an ethics history is a simple means of obtaining useful i
nformation about patients' preferences.