0
Editor's Correspondence |

Advance Care Planning of the Acutely Unwell Patient—Reply

Henry T. Stelfox, MD, PhD, FRCPC; Sean M. Bagshaw, MD, MSc, FRCPC
Arch Intern Med. 2012;172(16):1268-1269. doi:10.1001/archinternmed.2012.2956.
Text Size: A A A
Published online

Extract

In reply

We agree with Dr Arulkumaran that advanced care planning is essential to provide acutely ill patients will high-quality patient-centered care. A few points of clarification may be helpful.

First, we doubt that our results can be entirely explained by poor decision making. Goals of care were documented in the electronic health record for all patients included in our study, although it is unclear whether this reflects advanced care planning.1 In addition, the association between intensive care unit (ICU) bed availability and changes in goals of patient care was observed for patients with resuscitative goals of care and patients with medical goals of care, a group who clearly has experienced some advanced care planning. Nevertheless, we agree that goals of care should be prospectively defined for all patients and that resource scarcity should not be the factor that initiates clinician-patient discussion of potential therapeutic options. To provide high-quality patient care, we need to ensure that care is consistent with both clinical goals and patients' own goals.2

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

September 10, 2012
Nishkantha Arulkumaran, MRCP
Arch Intern Med. 2012;172(16):1268-1269. doi:10.1001/archinternmed.2012.2518.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();