PT  - JOURNAL ARTICLE
AU  - Robert Bernstein
TI  - Commentary: The Climate for Physician Adherence to Psychiatric Advance Directives
DP  - 2006 Sep 01
TA  - Journal of the American Academy of Psychiatry and the Law Online
PG  - 402--405
VI  - 34
IP  - 3
4099  - http://jaapl.org/content/34/3/402.short
4100  - http://jaapl.org/content/34/3/402.full
SO  - J Am Acad Psychiatry Law2006 Sep 01; 34
AB  - Factors that may be significant in rationalizing physician overrides of psychiatric advance directives (PADs) are not only features of individual clinical scenarios, but also are artifacts of the faltering mental health system being navigated by both provider and patient. This system, frequently viewed as hostile to consumer choice and increasingly focused on reacting to recurrent crises, is not predisposed to accepting proactive, person-centered measures such as PADs. In fact, PADs may hold great promise in improving clinical outcomes and even reducing system costs. But to realize the full potentials of PADs requires that providers understand their roles in challenging or perpetuating problems in the larger mental health system.