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Common Problems in Acute Care Surgery pp 495–504Cite as

Advanced Directives

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Abstract

Acute care surgeons are working with patients at the end of their lives with increasing frequency. The elderly have been the most rapidly enlarging segment of the population over the last century due to the combined effects of the “baby boom” (the population growth during the two decades after World War II) and the increase in average life expectancy. This trend shows no signs of abating, and with the blessing of increased life span has come the burden of chronic disease and disability [1]. According to Medicare data, nearly one-third of Americans underwent surgery during the last year of their life. Further, 18 % underwent procedures in the last month of life, and 8 % during the last week of life [2]. Clearly it is important for the acute care surgeon to understand the issues surrounding end-of-life care. These include advanced directives and “Do-Not Resuscitate” (DNR) orders, especially in the operating room. In addition, we must have the skills needed to discuss end of life care with patients and their families with honesty and compassion, including withdrawal of non-beneficial therapies and transition to comfort measures.

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Authors and Affiliations

  1. Department of Surgery, University of Pittsburgh Medical Center, Presbyterian University Hospital, 200 Lothrop Street, F1266.2, Pittsburgh, PA, 15213, USA

    Gary T. Marshall M.D.

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  1. Gary T. Marshall M.D.
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Correspondence to Gary T. Marshall M.D. .

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Editors and Affiliations

  1. Science Center, Department of Surgery, The University of Texas Health, 6431 Fannin Street, MSB 4.292, Houston, 77030, Texas, USA

    Laura J. Moore

  2. The Methodist Hospital, Department of Surgery, Weill Cornell Medical College, 6550 Fannin St, SM 1661A, Houston, 77030, Texas, USA

    Krista L. Turner

  3. School of Medicine, Department of Surgery, New York University, 550 First Avenue, New Bellevue 15 East 9, New York, 10016, New York, USA

    S. Rob Todd

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Marshall, G.T. (2013). Advanced Directives. In: Moore, L., Turner, K., Todd, S. (eds) Common Problems in Acute Care Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6123-4_41

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  • DOI: https://doi.org/10.1007/978-1-4614-6123-4_41

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