Advance care planning

被引：52

作者：

Emanuel, LL

von Gunten, CF

Ferris, FD

机构：

[1] Northwestern Univ, Sch Med, Project Educate Phys End Life Care, Interdisciplinary Program Professionalism & Human, Chicago, IL 60611 USA

[2] Northwestern Univ, Sch Med, Dept Med, Chicago, IL 60611 USA

[3] San Diego Hospice, Ctr Palliat Studies, San Diego, CA USA

[4] Univ Calif San Diego, Sch Med, Dept Med, San Diego, CA 92103 USA

[5] Univ Toronto, Dept Family & Community Med, Toronto, ON M5S 1A1, Canada

来源：

ARCHIVES OF FAMILY MEDICINE | 2000年 / 9卷 / 10期

关键词：

D O I：

10.1001/archfami.9.10.1181

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Advance care planning is the process of planning for future medical care, particularly for the event when the patient is unable to make his or her own decisions. It should be a routine part of standard medical care and, when possible, conducted with the proxy decision maker present. It is helpful to think of the process as a stepwise approach. The steps include the appropriate introduction of the topic, structured discussions covering potential scenarios, documentation of preferences, periodic review and update of the directives, and application of the wishes when needed. The steps can be integrated flexibly into routine clinical encounters by the physician and other members of the health care team. The process fosters personal resolution for the patient, preparedness for the proxy, and effective teamwork for the professionals. The process also has pitfalls of which to be aware.

引用

页码：1181 / 1187

页数：7