RT Journal
A1 Stelfox HT, Bagshaw SM
T1 ADvance care planning of the acutely unwell patient—reply
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2012
FD September 10
VO 172
IS 16
SP 1268
OP 1269
DO 10.1001/archinternmed.2012.2956
UL http://dx.doi.org/10.1001/archinternmed.2012.2956
AB 
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