Advance Directive and USA 预设医疗指示在美国
According to Wikipedia, advance directives were created in response to the increasing sophistication and prevalence of medical technology. Of U.S. deaths, 25–55% occur in health care facilities. Numerous studies have documented critical deficits in the medical care of the dying; it has been found to be unnecessarily prolonged, painful, expensive, and emotionally burdensome to both patients and their families.
Aggressive medical intervention leaves nearly two million Americans confined to nursing homes, and over 1.4 million Americans remain so medically frail as to survive only through the use of feeding tubes. As many as 30,000 persons are kept alive in comatose and permanently vegetative states.
Cost burdens to individuals and families are considerable. A national study found that: “In 20% of cases, a family member had to quit work;” 31% lost “all or most savings” (even though 96% had insurance); and “20% reported loss of [their] major source of income.” Yet, studies indicate that 70-95% of people would rather refuse aggressive medical treatment than have their lives medically prolonged in incompetent or other poor prognosis states.
Living wills proved to be very popular, and by 2007, 41% of Americans had completed a living will. On July 28, 2009, Barack Obama became the first United States President to announce publicly that he had a living will, and to encourage others to do the same.