Redefining the “Planning” in Advance Care Planning: Preparing for End-of-Life Decision Making

By R. Sudore, T. Fried. Annals of Internal Medicine, 2010

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The traditional objective of advance care planning has been to have patients make treatment decisions in advance in an attempt to provide care consistent with their goals. We argue that the objective for advance care planning ought to be the preparation of patients and surrogates to participate with clinicians in making the best possible in-the-moment medical decisions. We provide practical steps for clinicians to help patients and surrogate decision makers achieve this objective in the outpatient setting. Preparation for in-the-moment decision making shifts the focus from having patients make premature decisions based on incomplete information to preparing patients and their surrogates for the types of decisions and conflicts they may encounter when they do have to engage in in-the-moment decision making. This approach does not preclude the completion of advance directives, but acknowledges that they are but one piece of information to be used at the time of decision making.

Subfields: General Health Professions, Public Health, Environmental and Occupational Health

View Paper: https://www.semanticscholar.org/paper/69aab2f95a734e2bbf926ddf07cdb63518423536

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