Occupational Differences in Advance Care Planning: Are Medical and Legal Professionals More Likely to Plan?

• In Event: 343 - Section on Medical Sociology Roundtables (one-hour)
  In Refereed Roundtable: Table 07. Healthcare Professions I

Abstract

Advance care planning (ACP) is widely recommended as a strategy to help dying patients make choices about their own end-of-life care. ACP comprises a living will, which states one’s treatment preferences, and a durable power of attorney for health care (DPAHC), which designates an individual to serve as the patient’s decision maker. Despite the importance of ACP, only half of all U.S. adults have done so. The sociodemographic correlates of ACP are well documented, yet we are unaware of studies exploring whether occupational disparities exist. We hypothesize that persons working in medical and legal occupations would have higher rates of ACP, given their exposure to and knowledge of the medical and legal challenges faced by dying patients and their families. Using data from the 1986 to 2011 waves of the Americans’ Changing Lives (ACL) survey, we explore ACP patterns among persons working in medical occupations; legal occupations; other professional occupations; and other non-professional occupations (n=1173). Multivariate analyses are adjusted for demographic, socioeconomic, health, and psychological factors that could potentially confound the association between occupation and ACP. We found no evidence that medical and legal workers are more likely to engage in ACP. Persons working in other professional occupations had significantly higher odds of doing ACP relative to their non-professional counterparts, although this effect was fully accounted for by their superior socioeconomic resources. We discuss the implications of our findings for developing policies and practices to increase end-of-life preparations.

Authors

• Deborah Carr, State University of New Jersey-Rutgers

• Katherine Y. Lin, University of Michigan

• Sarah Burgard, University of Michigan