Barriers that predict resistance to completing a living will

Abstract

We sought to identify perceived barriers and benefits to completing living wills for 176 medical outpatients or their family members, using a questionnaire based on the Health Belief Model. The regression equation of the patient data identified two items that functioned as significant barriers: "I am not very interested in a living will because I believe that I will live a lot longer," and "Completing a living will now is difficult because I would likely change my mind about how I want to be managed during terminal illness." No variables remained in the equation when family member data were analyzed. We conclude that a major barrier to the completion of living wills (and perhaps advance directives generally) is that they connote personal death. Implications are explored.