Advance care planning

Advance care planning in primary care.

Advance care planning and the older patient.

Making treatment decisions for older people is difficult, because of the complex interplay of their multiple co-morbidities, but also because of the fine balance of risks vs. benefit in any chosen management plan. This becomes even more difficult when they lose the capacity to tell us what they want, and often in such situations we have to rely on information from others in order to make decisi...

Autonomy, liberalism and advance care planning.

The justification for advance directives is grounded in the notion that they extend patient autonomy into future states of incompetency through patient participation in decision making about end-of-life care. Four objections challenge the necessity and sufficiency of individual autonomy, perceived to be a defining feature of liberal philosophical theory, as a basis of advance care planning. The...

Towards realistic and flexible advance care planning.

The suffering of the many Irish people who bought houses at the height of the economic boom with variable mortgages is a topical and telling demonstration of the difficulties of planning for the future. What seemed like a good idea in 2006 has become a millstone around many necks, putting huge strains on marriages and family life, and is deservedly a topic of national debate. Signing into a bin...

Advance care planning in the elderly.

Key components of advance care planning (ACP) for the elderly include choosing a surrogate decision maker, identifying personal values, communicating with surrogates and clinicians, documenting wishes in advance directives, and translating values and preferences for future medical care into medical orders. ACP often involves multiple brief discussions over time. This article outlines common ben...