PMID: 16639971Apr 28, 2006Paper

An approach to advance care planning in the office.

Canadian Family Physician Médecin De Famille Canadien
Romayne Gallagher

Abstract

To outline how advance care planning is a process of communication among patients, their families, and health care providers regarding appropriate care for patients when they are no longer able to make decisions for themselves. Level I evidence supports systematic implementation of advance care planning under controlled circumstances, such as in institutions. Level II evidence supports exploring factors that determine treatment preferences and change treatment preferences and other factors that complicate the process of end-of-life decision making. Level III evidence supports the approach to advance care planning in the office described in this article. Family physicians can help prevent the suffering of patients with chronic illnesses by facilitating discussion of end-of-life issues. The approach suggested in this article will help reduce avoidance of the issues and minimize the difficulty of discussing issues crucial to patients and their families. Advance care planning can prevent suffering and enable patients to receive care congruent with their goals at the end of their lives. Family physicians can be key to facilitating this process.

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