Advance Care Directive pitfalls

Article published 22 November 2019

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DOCTORS are struggling to fulfil the healthcare wishes of people even with Advance Care Directives (ACD) available to guide them.

An ACD is a written record of someone’s preferences for future care, typically end-of-life care. An ACD aims to promote healthcare that is consistent with someone’s values, life goals and preferred outcomes or directions about care, at a time when someone may not be able to communicate these decisions themselves.

A recent study has found that doctors are not always following the directions of patient directives when they conflict with doctors’ own judgement.

The study found that doctors tended to ignore ACDs when ACDs were old, vague or incoherent.

Doctors also tended to put the ACD aside when family of the person in medical care opposed what was in the ACD.

In cases where a patient was faced with a condition that the doctor deemed to be potentially reversible, doctors also were inclined to ignore the patient’s ACD.

Obviously, if doctors did not have ready access to a patient’s ACD, they could not act in accordance with the wishes expressed in the ACD.

Anyone wanting to make sure that their ACD is taken seriously and is adhered to by medical professionals needs to avoid these pitfalls.

Contacting Advance Care Planning Australia (ACPA) may be helpful in developing an ACD that is clear and easy for a doctor to follow.

ACPA is a national program funded by the Australian Government with the aim of enabling Australians to make the best choices for their life and health care. You can contact ACPA’s free advice line on 1300 208 582 from 9am – 5pm Monday to Friday.

ACPA offer free personalised advance care planning advice informing you of how to make sure your preferences are heard, how to choose a substitute decision-maker and how to complete an ACD.

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