Reconceptualizing Advance Care Planning From the Patient's Perspective

Abstract

DEATH IS often preceded by the use of life-sustaining treatments, but patients are often incapable of making decisions about treatment at such times. Therefore, people sometimes use advance care planning (ACP) to make these decisions ahead of time. Four traditional academic assumptions about ACP have been advocated in various sources in the medical literature: (1) the purpose of ACP is preparing for incapacity^1,2; (2) ACP is based on the ethical principle of autonomy and the exercise of control^3-5; (3) the focus of ACP is completing written advance directive (AD) forms^6-8; and (4) ACP occurs within the context of the physician-patient relationship.^2,7,9-11