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Structured advance planning. Is it finally time for physician action and reimbursement?
1Division of Medical Ethics, Harvard Medical School, Boston, Mass 02115, USA.
JAMA
|August 9, 1995
Summary
Advance directives are evolving and ready for widespread implementation. Key actions include physician training, institutional support, and policy adjustments for better advance care planning.
Area of Science:
- Medical Ethics
- Healthcare Policy
- Patient Autonomy
Background:
- Advance directives have evolved significantly in healthcare.
- Current interventions in medicine are continuously developing.
- The field is poised for initiatives promoting broader adoption.
Discussion:
- Physicians in ambulatory care should cosign advance care documents.
- Institutions should offer validated worksheets for clinical use.
- Physician education on conducting advance planning is crucial.
Key Insights:
- Integrating advance planning into reimbursement systems is recommended.
- Medical law requires adjustment for incompetence categories.
- Further research is needed to refine advance care planning.
Outlook:
- Widespread adoption of advance directives is achievable.
- Continuous improvement in advance care planning is essential.
- Policy and legal frameworks must support patient autonomy.