C S Hartog1,2, S Michl3. 1. Klinik für Anästhesie mit Schwerpunkt operative Intensivmedizin, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. christiane.hartog@charite.de. 2. Klinik Bavaria Kreischa, Kreischa, Deutschland. christiane.hartog@charite.de. 3. Medical Humanities und Medizinethik, Institut für Geschichte der Medizin und Ethik in der Medizin, Charité - Universitätsmedizin Berlin, Thielallee 71, 14195, Berlin, Deutschland. susanne.michl@charite.de.
Abstract
BACKGROUND: Lack of knowledge about patient preferences is a contributing factor for inappropriate therapy. Advance care planning (ACP) is a novel concept for meaningful advance directives, but it is still not widely known in Germany. OBJECTIVE: An overview of the concept of ACP, development and its implementation with respect to intensive care is provided. METHODS: A narrative literature review was performed. RESULTS: ACP is a broad concept which requires facilitated discussions with trained medical staff. The process can lead to different ACP documents. It is also possible to facilitate discussions with patient proxies. Furthermore, ACP has potential because of the proven validity of advance directives and the prompt applicability of directives in an emergency. Prerequisites for ACP include the provision of resources, notably for the training of appropriate facilitators, and the implementation or extension of counseling structures. CONCLUSIONS: Advanced care planning (ACP) is a promising concept. However, some requirements must be met to implement ACP into daily practice.
BACKGROUND: Lack of knowledge about patient preferences is a contributing factor for inappropriate therapy. Advance care planning (ACP) is a novel concept for meaningful advance directives, but it is still not widely known in Germany. OBJECTIVE: An overview of the concept of ACP, development and its implementation with respect to intensive care is provided. METHODS: A narrative literature review was performed. RESULTS: ACP is a broad concept which requires facilitated discussions with trained medical staff. The process can lead to different ACP documents. It is also possible to facilitate discussions with patient proxies. Furthermore, ACP has potential because of the proven validity of advance directives and the prompt applicability of directives in an emergency. Prerequisites for ACP include the provision of resources, notably for the training of appropriate facilitators, and the implementation or extension of counseling structures. CONCLUSIONS: Advanced care planning (ACP) is a promising concept. However, some requirements must be met to implement ACP into daily practice.
Authors: Jürgen In der Schmitten; Katharina Lex; Christine Mellert; Sonja Rothärmel; Karl Wegscheider; Georg Marckmann Journal: Dtsch Arztebl Int Date: 2014-01-24 Impact factor: 5.594
Authors: Geraldine de Heer; Bernd Saugel; Barbara Sensen; Charlotte Rübsteck; Hans O Pinnschmidt; Stefan Kluge Journal: Dtsch Arztebl Int Date: 2017-06-05 Impact factor: 5.594
Authors: Nadja Leder; Daniel Schwarzkopf; Konrad Reinhart; Otto W Witte; Rüüdiger Pfeifer; Christiane S Hartog Journal: Dtsch Arztebl Int Date: 2015-10-23 Impact factor: 5.594