緩和ケアと医学

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The Importance of Advance Care Planning for Palliative Procedures

Ashley Sweet, Karen Brasel, Tera Cushman

Palliative interventions for patients facing life-limiting illness can dramatically improve quality of life but also have the potential to engender further suffering. Providers across disciplines must set aside time for advance care planning with patients and their surrogate decision makers prior to any palliative procedure. These discussions should thoroughly explore patient expectations and hopes for surgery, address the possibility and acceptability of postoperative lifesustaining treatments, clarify perioperative code status, help surrogates prepare for their role, and be documented in a central, accessible location in the medical record. Together, these components will maximize our ability to reduce conflict, surrogate burden, and provide goal-concordant care for patients in the last stages of illness.