Advanced Care Planning: An Option for Quality End-of-Life Care

Abstract

What is it? It would be inconceivable to any American to be forced to do something or be subjected to any treatment they disagree about. This is not the reality to many Americans, however, who face their last moments. Unfortunately, many Americans are still subjected to treatments, procedures, and medication they have not authorized. Advance Care Planning (ACP) is a process about reflection of goals and values and communicating them to family or friends to guarantee a patient’s wishes can be met if they are incapable in a life threating illness or an unexpected event. ACP is for every patient, their family, and the healthcare professionals involved in their care (McMahan, Knight, Fried & Sudore, 2013; Howard, et al., 2015; Respecting Choices, 2011). Legality According to the Universal Declaration of Bioethics and Human Rights (2006), no interest should overcome the well-being of an individual. The Declaration of Human Rights (1998), states that no one should go under inhumane or degrading treatment. The right to choose what treatments patients would like to receive or not is also defended by the bioethical principle of autonomy and the Patient Self-Determination Act (PSDA) (1990), a federal law that should be complied in order to people can control decisions that affect their health. Benefits Allowing patients to choose what care they would like to receive in their final moments of life guarantees dignity. By preventing unwanted treatments and procedures and guaranteeing their most important wishes. Preventing them to go under treatments that are not beneficial for them and guaranteeing they will have things that are really important to them (Houben, Spruit, Groenen, Wouters, & Janssen, 2014). It is not possible to scientifically prove the benefits of ACP, but considering that ACP proposes a dialogue between a patient and those involve in their care, it shows benefits their relationship and prevents disagreements when the time to call for actions arrives (Kolarik, Arnold, Fischer & Tulsky, 2002, Sudore, et al., 2017). Howard, M., Bernard, C., Tan, A., Slaven, M., Klein, D., & Heyland, D. K. (2015). Advance care planning: Let’s start sooner. Canadian Family Physician, 61, 663–665. https://doi.org/10.7748/nop.29.4.19.s20 Houben, C. H. M., Spruit, M. A., Groenen, M. T. J., Wouters, E. F. M., & Janssen, D. J. A. (2014). Efficacy of advance care planning: A systematic review and meta-analysis. Journal of the American Medical Directors Association, 15(7), 1–13. https://doi.org/10.1016/j.jamda.2014.01.008 Kolarik, R. C., Arnold, R. M., Fischer, G. S., & Tulsky, J. A. (2002). Objectives for Advance Care Planning. Journal of Palliative Medicine, 5(5), 697–704. https://doi.org/10.1089/109662102320880516 McMahan, R. D., Knight, S. J., Fried, T. R., & Sudore, R. L. (2013). Advance care planning beyond advance directives: Perspectives from patients and surrogates. Journal of Pain and Symptom Management, 46(3), 355–365. https://doi.org/10.1016/j.jpainsymman.2012.09.006 Organização das Nações Unidas. (1998). Declaração Universal dos Direitos Humanos. Brasília. Respecting Choices. (2011). First Steps ACP Interview Tool. United States of America. Sudore, R. L., Lum, H. D., You, J. J., Hanson, L. C., Meier, D. E., & Pantilat, S. Z. (2017). Defining advance care planning for adults: a consensus definition from a multidisciplinary delphi panel. Journal of Pain and Symptom Management, 53(5), 821–832. The Patient Self-Determination Act. A matter of life and death. - PubMed - NCBI. ([s.d.]). Retrieved February 17th ,2020, from https://www.ncbi.nlm.nih.gov/pubmed/10141946 UNESCO. (2006). Declaração Universal sobre Bioética e Direitos Humanos. Lisboa. U.S. Congress: Patient Self-Determination Act. Omnibus Budget Reconciliation Act (OBRA), Pub L 101- 508 (1990).