Advance Care Planning in Belgium

Area of Science:

• Healthcare Policy
• Medical Ethics
• Public Health

Background:

• Belgium established a medicolegal framework for Advance Care Planning (ACP) with the Patient's Right Law in 2002.
• Various initiatives, including standardized documentation and physician reimbursement, have been introduced to enhance ACP uptake.

Purpose of the Study:

• To describe the current state of Advance Care Planning (ACP) development in Belgium since 2002.
• To identify challenges and opportunities for ACP implementation, offering insights for similar countries.
• To support the advancement of ACP practice and research within Belgium.

Main Methods:

• Consultation with local researchers and 12 domain experts.
• Review of grey literature, including regulatory documents, policy documents, and practice guidelines.
• Analysis of Advance Care Planning (ACP), palliative care, and related healthcare topics in the Belgian context.

Main Results:

• Despite initiatives like standardized documentation and reimbursement codes, ACP efforts are often profession-specific and lack a unified communication platform.
• Patient groups primarily targeted are those with cancer and older adults, with limited focus on those with low health literacy or minority groups.
• A significant barrier remains the lack of a unified system for exchanging ACP outcomes and advance directives among healthcare professionals.

Conclusions:

• Current Advance Care Planning (ACP) in Belgium is characterized by fragmented, documentation-centric initiatives rather than integrated, interprofessional approaches.
• Addressing the lack of a unified communication platform and expanding focus beyond traditional patient groups are crucial for future ACP development.
• Further research and policy development are needed to overcome identified barriers and promote comprehensive ACP practice in Belgium.