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Advance Care Planning, Shared Decision Making, and Serious Illness Conversations in Onconephrology
Amanda Jane Reich1, John Adam Reich2, Paul Mathew3
1Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA.
Abstract:
Advance care planning, shared decision making, and serious illness conversations are communication processes designed to promote patient-centered care. In onconephrology, patients face a series of complex medical decisions regarding their care at the intersection of oncology and nephrology. Clinicians who aim to ensure that patient preferences and values are integrated into treatment planning must work within a similarly complex care team comprising multiple disciplines. In this review, we describe key decision points in a patient's care trajectory, as well as guidance on how and when to engage in advance care planning, shared decision making, and serious illness discussions. Further research on these processes in the complex context of onconephrology is needed.
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