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Title: Advance directives, perioperative care and end-of-life planning.
Austin Authors: Silvester, William;Detering, Karen M 
Affiliation: Austin Hospital, Burgundy St., Heidelberg 3084, Melbourne, Australia
Issue Date: 1-Sep-2011
Publication information: Best Practice & Research. Clinical Anaesthesiology; 25(3): 451-60
Abstract: It is ethically and legally important, when providing care to our patients, to respect their autonomy and dignity, to act in their best interests and avoid doing harm. Advance care planning is essential to achieving this by giving patients the opportunity to tell us what they would want us to do if they became seriously unwell and could no longer communicate their wishes. Whereas earlier attempts at advance care planning focussed on the completion of forms, the more recent, successful focus has been on the patient-centred discussion, involving family, appointment of substitute decision makers and identification of what the patient would see as an acceptable outcome from any proposed treatment. Advance care planning is successful in caring for the elderly, including in the perioperative setting. There is an increasing focus on improving end-of-life care, including the prevention of suffering, making earlier and wiser end-of-life decisions about the appropriateness of treatment and improving communication with patients and families. New awareness of the poor outcomes from cardiopulmonary resuscitation (CPR) is catalysing reassessment of the appropriateness of this intervention.
Gov't Doc #: 21925409
DOI: 10.1016/j.bpa.2011.07.005
Type: Journal Article
Subjects: Advance Care Planning
Advance Directives
Cardiopulmonary Resuscitation
Decision Making
Ethics, Medical
Perioperative Care
Terminal Care
Appears in Collections:Journal articles

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