ADVANCE CARE PLANNING - ELICITING PATIENT PREFERENCES FOR LIFE-SUSTAINING TREATMENT

Patient autonomy is a guiding principle in medical decision-making in America. This is challenging when patients become mentally incapacitat ed and cannot express their preferences. Advance care planning (ACP) a ddresses this challenge. ACP is a deliberative and communicative proce ss that helps people formulate and communicate preferences for future medical care in the event of mental incapacity. Advance directives are mechanisms for communicating and/or documenting ACP, and are either i nstructional (e.g. statement of treatment preferences in living wills) or proxy types (e.g, appointment of another person to speak on the pa tient's behalf). ACP discussions between patients and health care prov iders and patient-orientated educational ACP materials often ignore in sights from 2 related activities, health promotion and human informati on processing. More effective ACP should occur with greater attention to the concepts of stages of change and self-efficacy, the Health Beli ef Model, and the necessary requisites for cognitive integration.