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Table 3 Barriers to enacting ACDs (n = 118*)

From: Junior Medical Officers’ knowledge of advance care directives and substitute decision making for people without decision making capacity: a cross sectional survey

  Strongly agree Agree Disagree Strongly disagree
Uncertainty about the currency of the advance care directive (i.e., does it represent the patient’s current values and wishes?) 20 (17.5%) 78 (68.4%) 15 (13.2%) 1 (0.9%)
Uncertainty about the legal implications of enacting when a patient’s family or substitute decision maker disagree with the advance care directive 33 (29.2%) 64 (56.6%) 15 (13.3%) 1 (0.9%)
Difficulty accessing the advance care directive when treatment decisions need to be made 41 (36%) 51 (44.7%) 19 (16.7%) 3 (2.6%)
Poor knowledge among doctors about what constitutes a legally binding advance care directive 23 (20.4%) 64 (56.6%) 24 (21.2%) 2 (1.8%)
Poor knowledge among doctors about the circumstances in which an advance care directive should be used 18 (15.8%) 48 (42.1%) 46 (40.4%) 2 (1.8%)
Lack of detail and specificity within the advance care directive to meaningfully guide decision making 24 (21.1%) 59 (51.8%) 30 (26.3%) 1 (0.9%)
Use of vague language in the advance care directive, which makes it difficult to use it to meaningfully guide decision making 28 (24.6%) 45 (39.5%) 40 (35.1%) 1 (0.9%)
Difficulty identifying a patient’s substitute decision maker 14 (12.3%) 59 (51.8%) 40 (35.1%) 1 (0.9%)
  1. *Row totals do not sum to 118 due to missing variables