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Related Experiment Videos

Advance care planning: pitfalls, progress, promise.

T J Prendergast1

  • 1Dartmouth Medical School, Pulmonary Section (3D), Lebanon, NH, USA.

Critical Care Medicine
|March 3, 2001
PubMed
Summary
This summary is machine-generated.

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Advance directives have not improved patient care or communication despite a decade of use. A new approach focusing on communication within patient relationships shows promise for better outcomes.

Area of Science:

  • Medical Ethics
  • Health Services Research
  • Patient-Centered Care

Background:

  • The Patient Self-Determination Act (PSDA) aimed to improve end-of-life care through advance directives.
  • A decade of experience with advance directives has yielded disappointing empirical results.
  • Studies show advance directives are recorded more often but not completed more frequently by patients.

Purpose of the Study:

  • To evaluate the effectiveness of advance directives and identify reasons for their limited impact.
  • To explore alternative models for advance care planning.
  • To propose a hopeful model for clinicians in intensive care units.

Main Methods:

  • Review of empirical studies on advance directives and their impact on care and communication.
Keywords:
Death and EuthanasiaStudy to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT)

Related Experiment Videos

  • Analysis of the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SPROUT) intervention.
  • Examination of recent research on patient preferences and relationship-based care.

    • Main Results:

    • Advance directives have not enhanced patient-physician communication or changed patient care.
    • The SPROUT study showed no change in outcomes despite an extensive intervention.
    • Interventions focused on communication within patient relationships have shown success.

    Conclusions:

    • Traditional approaches to advance care planning have largely failed to meet expectations.
    • Patient preferences are dynamic and emerge through discussion within social networks.
    • A communication-centered model, emphasizing trust and relationships, offers a promising approach for intensive care settings.