The goals of advance care planning are four-fold. In the event of decisional incapacity, they are to:

  • maximize the likelihood that medical care serves the patients goals,
  • minimize the likelihood of over- or undertreatment,
  • reduce the likelihood of conflicts between family members (and close friends) and health care providers, and
  • minimize the burden of decision making on family members or close friends.

    The goals of advance care planning are four-fold. In the event of decisional incapacity, they are to:

    • maximize the likelihood that medical care serves the patients goals,
    • minimize the likelihood of over- or undertreatment,
    • reduce the likelihood of conflicts between family members (and close friends) and health care providers, and
    • minimize the burden of decision making on family members or close friends.

    As a health care provider who engages her patient in advance care planning, you can expect to better understand your patient’s views about the goals of medicine, his preferred approach to end of life care, what makes life worth living, as well as his fears about medical interventions and loss of dignity. In addition, you can expect to have a discussion that clarifies misunderstandings.

    For example, patients often think that cardiopulmonary resuscitation is successful 80% of the time, that mechanical ventilation is a fancy word for nasal prongs, and that coma patients still have the ability to enjoy life.

    You can also expect to have better communication with the patient’s family members or loved ones because there should be enhanced shared understanding of the patient’s values and wishes. Thus, you can expect to have fewer conflicts with family members about the approach to end of life care.

    Advance directives will not be the outcome of most advance care planning. At a minimum patients should become familiar with the concept and rationale for advance care planning. Some patients will want to mull things over, others will want to discuss the topic with their close friends or family and health care providers. Fewer will be ready to sign documents and even fewer will be interested in personalizing their advance directives so that they are clear and contain pertinent information with clinical relevance.