This paper reviews the results of a pilot study also conducted in the United States, Germany and Chile, the physician decision-making survey of Rothenberg et al. of the Volkswagen Foundation-Kennedy Institute project. The views of university physicians caring for adult patients at an academic medical center concerning advance directives were surveyed. Given a case, almost all respondents chose the option the doctor and family decide the treatment for the demented patients. The process used to decide which person to discuss the (...) treatment was a mixture of relatives and those caring for the patient, and those in the family who have the best ability to decide. The most important factor in making the decision was what is considered best for the patient, followed by the family will. (shrink)