Objective: This study used qualitative methods to explore patients' beliefs about control of their end-of-life health and health care.
Method: The authors recruited 30 elderly patients from a large, urban Veterans Administration medical center in the United States and engaged them in semistructured interviews about end-of-life care concepts. Using grounded theory methods, they coded, categorized, and compared responses.
Results: The authors discovered that patients' decisions about using life sustaining treatment were interconnected with their beliefs about their degree of control over circumstances and the role of external factors, including a higher power; institutions and individuals; medical interventions; medical conditions; and luck, chance, or fate.
Discussion: The results shed light on why patients do or do not take active roles in advance decisions concerning the use of life-sustaining treatment.