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==Background== Advance directives were created in response to the increasing sophistication and prevalence of medical technology.<ref>{{cite journal | author = Childress J | year = 1989 | title = Dying Patients. Who's in Control? | journal = Law, Medicine and Health Care| volume = 17 | issue = 3| pages = 227β228 | doi = 10.1111/j.1748-720x.1989.tb01099.x | s2cid = 57182781 }}</ref><ref name="ReferenceA">Choice in Dying (now: Partnership in Caring). ''Choice in Dying: an historical perspective.'' CID 1035-30th Street, N.W. Washington, DC. 2007</ref> Numerous studies have documented critical deficits in the medical care of the dying; it has been found to be unnecessarily prolonged,<ref>Callahan, D. ''Setting Limits'' Simon & Schuster. 1983</ref> painful,<ref>{{cite journal | year = 1995 | title = A controlled trial to improve care for seriously ill hospitalized patients: the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) | journal = Journal of the American Medical Association | volume = 274 | issue = 20| pages = 1591β1598 | doi = 10.1001/jama.1995.03530200027032 }}</ref> expensive,<ref>{{cite journal | author = Lubitz J, Riley GF | year = 1993 | title = Trends in Medicare payments in the last year of life | journal = New England Journal of Medicine | volume = 328 | issue = 15| pages = 1092β1096 | doi = 10.1056/nejm199304153281506 | pmid = 8455667 | doi-access = free }}</ref><ref>{{cite journal | author = Scitovsky A.A. | year = 1994 | title = The High Cost of Dying, Revisited | journal = Milbank Quarterly | volume = 72 | issue = 4| pages = 561β591 | doi = 10.2307/3350356 | jstor = 3350356 | pmid = 7997219 }}</ref> and emotionally burdensome to both patients and their families.<ref>{{cite journal | year = 1991 | title = Guidelines for the Appropriate Use of Do-Not-Resuscitate Orders. Council on Ethical and Judicial Affairs | journal = Journal of the American Medical Association | volume = 265 | issue = 14| pages = 1868β1871 | doi = 10.1001/jama.265.14.1868 }}</ref><ref>{{cite journal | author = McGrath RB | year = 1987 | title = In-house Cardiopulmonary resuscitation -- after a quarter of a century | journal = Annals of Emergency Medicine | volume = 16 | issue = 12| pages = 1365β1368 | doi = 10.1016/s0196-0644(87)80420-1 | pmid = 3318591 }}</ref><!-- Medicare, providing a hospice benefit under, the government has, and in. "Remembering death: public policy in the USA." National Center for Biotechnology Information. N.p., n.d. Web. 24 Sept. 2010. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282180/]<ref>{{cite journal | author = Chambers CV, Diamond J, Perkel R, Lasch L | year = 1994 | title = Relationship of advance directives to hospital charges in a Medicare population | journal = Archives of Internal Medicine | volume = 154 | pages = 541β547 | doi = 10.1001/archinte.154.5.541 }}</ref><ref>{{cite journal | author = Dewar MA | year = 1994 | title = Advance Directives and Treatment Withdrawal: legal considerations | journal = Journal of the Florida Medical Association | volume = 81 | issue = 1| pages = 22β26 }}</ref>-->
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