Abstract
This article investigates the social‐cultural factors and other circumstances that influence decision making in the treatment of acute illness in three West Coast nursing homes. Participant observation, in‐depth interviews with physicians, nursing staff, nursing home residents, and family members, and event analysis were used to gather data. Using decision‐making theory as the theoretical framework, analysis focuses on how internal and external factors influence the decision‐making process. Two case studies are used to illustrate how in real‐life acute clinical situations, physicians frame decision problems, treatment plans, and expected outcomes in order to persuade residents and their families to comply with their preferred treatment plans.

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