Abstract
Background: Patients are encouraged to complete limitation-of-medical-treatment forms
(LMTFs), sometimes referred to as code status forms or do-not-resuscitate forms, before
admission to hospitals or other health care facilities in the United States. Objective:
The purpose of this study was to review, evaluate, and to assess the LMTFs currently
used in emergency medicine residency training programs throughout the United States.
Methods: In February 2009, researchers sent letters to all allopathic and osteopathic
emergency medicine residency program directors (n = 193) requesting a copy of the
LMTF used in their hospital. These forms were evaluated for content, consistency,
and readability. Results: Sixty-five responses were received (corrected response rate
= 34%); 45 LMTFs were reviewed. Nineteen LMTFs required the signature of the patient,
or the patient's appointed durable power of attorney for health care. The readability
ranged from 11th to 17th grade (mean ± SD = 13.16 ± 1.77), greatly exceeding the average
Americans' 8th-grade reading level. Conclusions: Our findings demonstrate that there is no standardization
across LMTFs currently used in hospitals throughout the United States, and these forms
are written above the literacy level of the average American adult. Therefore, there
is a need to develop and disseminate an LMTF that is both consistent and better understood
by the average American adult.
Keywords
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Article info
Publication history
Published online: April 30, 2010
Accepted:
February 18,
2010
Received in revised form:
December 4,
2009
Received:
September 29,
2009
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
