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Doctor Facilitated Denial Summary

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“Doctor Facilitated Denial: A Barrier to End-of-life Planning Among COPD Patients” conducted by Lauren Seidman, examined the correlation between the number of severe COPD patients who decide to pursue advanced care planning, and certain motivations behind this decision such as denial (facilitated or refuted by doctors), self-perceived health, and the patient’s trust in the advice of the physician. Seidman utilized data previously collected through decision aids such as the web program InformedTogether, as well as conducted her own research based on recorded medical meetings and surveys from a small, non diversified sample at North Shore Long Island Jewish Pulmonary Clinics. Also, theoretical bases such as the Integrative Model of Behavior Prediction, …show more content…

First, the sample population worked with from North Shore Long Island Jewish Pulmonary Clinics was very small and not very diverse. Although it is most necessary for patients with severe COPD to plan an Advance Directive, it might have been more constructive to work with patients of all severities of COPD, as commonly those who suffer from a severe disease often have self-denial, which would skew the results even more than the doctor facilitated denial had. Patients with milder forms of COPD may have approached the meetings with more of an open mind than those with severe forms of COPD. Next, the results collected from the examined motivation of self-perceived health was not one of the more productive experiments, as self-perceived health relies heavily on both physician denial and with that, trust in medical information. If a patient is being told by his/her physician that his/her condition is milder than it really is, the self-perceived health would rank higher than those who had physicians who refuted denial. Thus, this data may not be reliable. Finally, neither an increase or decrease in motivation to pursue an Advance Directive was shown throughout Seidman’s data analysis. However, the factors that she used to conduct her research heavily relied on the major variable of physician facilitated denial. In Seidman’s “Qualitative Analysis and Categorization,” she argues that this denial is a large obstacle that hinders the motivation to pursue a treatment path, and that it has to be greatly diminished. However, Seidman fails to mention both how lessening this denial will affect the motivation of the patients (as those patients who had physicians that refuted denial appeared to have a greater decrease in motivation to create an

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