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Improving care at the end of life: How advance care planning can help

Published online by Cambridge University Press:  04 April 2005

JOHN C. MOSKOP
JOHN C. MOSKOP
Affiliation:
Department of Medical Humanities, The Brody School of Medicine, East Carolina University, Greenville, North Carolina
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Abstract

Based on a comparison of studies of patient desires regarding end-of-life care and of the actual course of end-of-life care, this article concludes that there is a significant discrepancy in the United States between the kind of care most people want and the kind of care they in fact receive. The article offers a case example to illustrate one type of dilemma commonly encountered in end-of-life care. It then introduces and describes the practice of advance care planning. Use of advance care planning, it is argued, can prevent moral dilemmas and improve end-of-life care.

Keywords

Advance care planningAdvance directivesDeath and dyingEnd-of-life careMoral dilemmas
Type
REVIEW ARTICLES
Information
Palliative & Supportive Care , Volume 2 , Issue 2 , June 2004 , pp. 191 - 197
Copyright
© 2004 Cambridge University Press

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References

REFERENCES

American Medical Association. (1999). EPEC Participant's Handbook. Chicago: American Medical Association, pp. 1–7.
Becker, E. (1973). The Denial of Death. New York: Free Press.
Cassel, C.K. (1996). Overview on attitudes of physicians toward caring for the dying patient. In Caring for the Dying: Identification and Promotion of Physician Competency. Educational Resource Document. Philadelphia: American Board of Internal Medicine, pp. 1–4.
Committee on Care at the End of Life. (1997). Financial and economic issues in end-of-life care. In Approaching Death: Improving Care at the End of Life, Field, M.J. & Cassel, C.K. (eds.), pp. 154–187. Washington, DC: National Academy Press.
Emanuel, L.L., von Gunten, C.F., & Ferris, F.D. (1999). The Education for Physicians on End-of-Life Care (EPEC) Curriculum. Chicago: American Medical Association.
Hammes, B.J. & Briggs, L. (2000). Respecting Choices: Advance Care Planning Facilitator's Manual. La Crosse, WI: Gundersen Lutheran Medical Foundation, p. 2.1.
Hammes, B.J. & Rooney, B.L. (1998). Death and end-of-life planning in one midwestern community. Archives of Internal Medicine, 158, 383–390.Google Scholar
Moskop, J.C. (1989). Advance directives in medicine: Choosing among the alternatives. In Advance Directives in Medicine, Hackler, C., Moseley, R. & Vawter, D.E. (eds.), pp. 9–19. New York: Praeger.
Moskop, J.C. (1999). Ethics controversies in a changing medical environment: Managed care, futility, and assisted death. Annals of Behavioral Science and Medical Education, 6, 41–48.Google Scholar
Murphy, D.J. (1988). Do-not-resuscitate orders: Time for reappraisal in long-term-care institutions. JAMA, 260, 2098–2101.Google Scholar
North Carolina Department of the Secretary of State. Advance health care directives registry. www.nclifelinks.org/ahcdr/. Accessed February 16, 2004.
Orentlicher, D. (1994). The limitations of legislation. Maryland Law Review, 53, 1255–1305.Google Scholar
President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. (1983). Deciding to Forego Life-Sustaining Treatment. Washington, DC: Author.
Silveira, M.J., DiPiero, A., Gerity, M.S., et al. (2000). Patients' knowledge of options at the end of life: Ignorance in the face of death. JAMA, 284, 2483–2488.Google Scholar
Singer, P.A., Martin, D.K., & Kelner, M. (1999). Quality end-of-life care: Patients' perspectives. JAMA, 281, 163–168.Google Scholar
Singer, P.A., Martin, D.K., Lavery, J.V., et al. (1998). Reconceptualizing advance care planning from the patient's perspective. Archives of Internal Medicine, 158, 879–884.Google Scholar
Steinhauser, K.E., Christakis, N.A., Clipp, E.C., et al. (2000). Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA, 284, 2476–2482.Google Scholar
The SUPPORT Principal Investigators. (1995). A controlled trial to improve care for seriously ill hospitalized patients. JAMA, 274, 1591–1598.Google Scholar
Teno, J.M., Clarridge, B.R., Casey, V., et al. (2004). Family perspectives on end-of-life care at the last place of care. JAMA, 291, 88–93.Google Scholar
U.S. Living Will Registry. www.uslivingwillregistry.com. Accessed February 16, 2004.