Inapplicability of advance directives in a paternalistic setting: the case of a post-communist health system
2011

Advance Directives in Albania's Paternalistic Health System

Sample size: 57 publication 10 minutes Evidence: moderate

Author Information

Author(s): Vyshka Gentian, Kruja Jera

Primary Institution: Biomedical & Experimental Department, Faculty of Medicine, Tirana, Albania

Hypothesis

How does the paternalistic approach of the Albanian health system affect the applicability of advance directives?

Conclusion

Advance directives are largely ineffective in Albania due to cultural, legal, and systemic barriers.

Supporting Evidence

  • Advance directives are rarely upheld in Albania due to a lack of legal provisions.
  • Medical teams often ignore verbal requests for treatment refusal.
  • Albanian culture tends to deny death, complicating end-of-life decisions.

Takeaway

In Albania, people can't easily refuse medical treatment, even if they want to, because the laws and culture make it hard for them to express their wishes.

Methodology

Interviews with relatives of elderly patients admitted to a neurological facility.

Potential Biases

Potential bias due to cultural beliefs and the emotional state of relatives during decision-making.

Limitations

The study is limited by the cultural context and the lack of formal legal recognition of advance directives in Albania.

Participant Demographics

Relatives of 57 elderly patients, primarily in a comatose state.

Digital Object Identifier (DOI)

10.1186/1472-6939-12-12

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