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10 - Advance care planning

Published online by Cambridge University Press:  30 October 2009

By
James A. Tulsky ,
Linda L. Emanuel ,
Douglas K. Martin  and
Peter A. Singer
Edited by
Peter A. Singer  and
A. M. Viens
James A. Tulsky
Affiliation:
Professor Duke University, Durham
Linda L. Emanuel
Affiliation:
Professor Northwestern University Chicago, USA
Douglas K. Martin
Affiliation:
Associate Professor University of Toronto, Canada
Peter A. Singer
Affiliation:
Professor University of Toronto, Canada
Peter A. Singer
Affiliation:
University of Toronto
A. M. Viens
Affiliation:
University of Oxford
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Summary

Mrs. G is 63 years old and has no significant history of illness. She presents for a routine visit to her family physician. She has read newspaper articles about living wills and thought that this was something she ought to address, but had never taken it further. In the physician's waiting room, she sees a leaflet on advance directives and decides that today would be a good day to learn more about this.

Mr. H is a 40-year-old man who was diagnosed 6 months ago with advanced glioblastoma multiforme, an incurable brain tumor. He presents to his oncologist with symptoms of early cognitive dysfunction. The physician considers what Mr. H should be told about advance directives.

What is advance care planning?

Advance care planning is a process whereby a patient, in consultation with healthcare providers, family members, and important others, makes decisions about his or her future healthcare (Teno et al., 1994). This planning may involve the preparation of a written advance directive (Emanuel et al., 1991). Completed by patients when they are capable, advance directives are invoked in the event that the patient loses decision making capacity. Advance directives may indicate what interventions patients would or would not want in various situations, and whom they would want to name as healthcare surrogates to make treatment decisions on their behalf.

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Type
Chapter
Information
The Cambridge Textbook of Bioethics , pp. 65 - 71
Publisher: Cambridge University Press
Print publication year: 2008

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References

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