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Death Before Life: An Analysis of Emerging Adults' Knowledge and Attitudes Regarding End-of-Life Decision Making

Kavalieratos, Dionysios (2008) Death Before Life: An Analysis of Emerging Adults' Knowledge and Attitudes Regarding End-of-Life Decision Making. Undergraduate Thesis, University of Pittsburgh. (Unpublished)

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This study sought to address the significant paucity in the medical decision making literature regarding the knowledge and attitudes of emerging adults toward advance care planning. Using a mostly qualitative approach, we attempted to document several dimensions of preferences and perspectives within a population well known for risk-taking behaviors, which may result in death, serious injury, and states of decisional incapacitation. Fifty-six undergraduates from two Pittsburgh universities took part in six focus group interviews between February-April 2007. Using a semi-structured focus group guide, participants were led through discussions on hypothetical end-of-life care scenarios, eliciting their views on Living Wills, Health Care Proxies, preferences for surrogates and their behaviors, and for life-sustaining treatment. Content analysis revealed inter-subject variability and intra-subject inconsistency among participants within all domains analyzed. Fifty-six percent of our sample had correct knowledge of advance directives, while only 10% understood that they offer proxy designation. Themes related to age-mediated invincibility, decreased risk perception, and an inexperience with morbidity and mortality relative to their elders emerged from the data. The findings of our study underscore the need for a through, quantitative effort to examine this volatile population's familiarity and attitudes regarding decisional incapacitation and the legal provisions in place to ensure autonomous and/or shared decision making. Additionally, we review the psychosocial literature related to advance care planning and apply it to this population, suggesting that current legal statutes are inappropriate for this age group, given their ongoing individuation and identity development.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBarnard, Davidbarnard@pitt.eduBARNARD
Committee MemberDegenholtz, Howarddegen@pitt.eduDEGEN
Committee MemberHartman, Rhonda Gayhartmanr@pitt.eduHARTMANR
Committee MemberKlein, Williamwmklein@pitt.eduWMKLEIN
Date: 6 October 2008
Date Type: Completion
Defense Date: 11 April 2008
Approval Date: 6 October 2008
Submission Date: 15 April 2008
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: David C. Frederick Honors College
Degree: BPhil - Bachelor of Philosophy
Thesis Type: Undergraduate Thesis
Refereed: Yes
Uncontrolled Keywords: advance directive; Cruzan; emerging adults; end of life; individuation; Quinlan; Schiavo; young adults; advance care planning; bioethics
Other ID:, etd-04152008-122211
Date Deposited: 10 Nov 2011 19:37
Last Modified: 15 Nov 2016 13:40


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