Hospital ehtics committees are often consulted when cmopeting patient interests blur an otherwise clear course of medical treatment. Nowhere is the potential for competing interests greater than in the field of abosterics, wherer obstetricians have traditionally viewed themselves as having two patients: the pregnant woman and the fetus.

This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs.