Effect of the Contents in Advance Directives on Individuals’ Decision-Making

Jae Yoon Park, Chi Yeon Lim, Gloria Puurveen, Do Yeun Kim, Jae Hang Lee, Han Ho Do, Kyung Soo Kim, Kyung Don Yoo, Hyo Jin Kim, Yunmi Kim, Sung Joon Shin

Research output: Contribution to journalArticle


Completing an advance directive offers individuals the opportunity to make informed choices about end-of-life care. However, these decisions could be influenced in different ways depending on how the information is presented. We randomly presented 185 participants with four distinct types of advance directive: neutrally framed (as reference), negatively framed, religiously framed, and a combination. Participants were asked which interventions they would like to receive at the end of life. Between 60% and 70% of participants responded “accept the special interventions” on the reference form. However, the majority (70%–90%) chose “refuse the interventions” on the negative form. With respect to the religious form, 70% to 80% chose “not decided yet.” Participants who refused special life-sustaining treatments were older, female, and with better prior knowledge about advance directives. Our findings imply that the specific content of advance directives could affect decision-making with regard to various interventions for end-of-life care.

Original languageEnglish
Pages (from-to)436-453
Number of pages18
JournalOmega (United States)
Issue number3
StatePublished - 1 Aug 2020


  • advance directives
  • decision-making
  • end-of-life care
  • framing effect
  • informed decision

Cite this

Park, J. Y., Lim, C. Y., Puurveen, G., Kim, D. Y., Lee, J. H., Do, H. H., Kim, K. S., Yoo, K. D., Kim, H. J., Kim, Y., & Shin, S. J. (2020). Effect of the Contents in Advance Directives on Individuals’ Decision-Making. Omega (United States), 81(3), 436-453. https://doi.org/10.1177/0030222818782344