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[Advance Care Planning-further development of the patient advance directive : What the anesthetist must know].
Anaesthesist. 2019 Dec 09 [Online ahead of print]A

Abstract

Despite the availability of the instruments of advance directives, power of attorney and healthcare proxy, the patient's preferences for life-sustaining medical treatment in a specific situation often remain unknown. The aim of the systemically designed German Advance Care Planning (ACP) program is the reflection, documentation and implementation of patients' preferences regarding future medical treatment in case they are incapable of legally binding decision-making. A specially trained ACP facilitator initially supports the verbalization of the attitudes towards life, severe illness and death on an individual level. Based on these principal views, concrete preferences on how to be treated under defined medical circumstances can be discussed and documented in an advance directive. This includes the three scenarios medical emergency, inpatient hospital treatment in situations with decisional incapability of unknown duration and the situation of permanent cognitive impairment. Through cautious, nondirective conversational techniques in the sense of shared decision-making, the person is enabled to reflect and decide well-informed according to the informed consent standard. All persons participating in decisions regarding future medical treatment, especially future surrogate decision makers, are involved in the process as early as possible. A systematic institutional and regional implementation of the concept is necessary to ensure that the carefully assessed and documented preferences of the patients will be known and honored. The new German § 132g of the Social Code Book V (SGB V) enables institutions for long-term care and for the care of disabled persons, to offer facilitated ACP to all residents at the expense of the statutory health insurance funds. An increased dissemination of this concept is to be expected.

Authors+Show Affiliations

Caritasverband der Erzdiözese München und Freising e. V., München, Deutschland.Klinik für Anästhesiologie, Klinikum der Universität München, LMU München, München, Deutschland.Institut für Allgemeinmedizin, Universitätsklinik Düsseldorf, Düsseldorf, Deutschland.Klinik und Poliklinik für Palliativmedizin, SAPV, Klinikum der Universität München, LMU München, Schillerstr. 40/III, 80336, München, Deutschland. berend.feddersen@med.uni-muenchen.de.

Pub Type(s)

English Abstract
Journal Article
Review

Language

ger

PubMed ID

31820016

Citation

Petri, S, et al. "[Advance Care Planning-further Development of the Patient Advance Directive : what the Anesthetist Must Know]." Der Anaesthesist, 2019.
Petri S, Zwiβler B, In der Schmitten J, et al. [Advance Care Planning-further development of the patient advance directive : What the anesthetist must know]. Anaesthesist. 2019.
Petri, S., Zwiβler, B., In der Schmitten, J., & Feddersen, B. (2019). [Advance Care Planning-further development of the patient advance directive : What the anesthetist must know]. Der Anaesthesist. https://doi.org/10.1007/s00101-019-00697-2
Petri S, et al. [Advance Care Planning-further Development of the Patient Advance Directive : what the Anesthetist Must Know]. Anaesthesist. 2019 Dec 9; PubMed PMID: 31820016.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Advance Care Planning-further development of the patient advance directive : What the anesthetist must know]. AU - Petri,S, AU - Zwiβler,B, AU - In der Schmitten,J, AU - Feddersen,B, Y1 - 2019/12/09/ PY - 2019/12/11/entrez PY - 2019/12/11/pubmed PY - 2019/12/11/medline KW - Advance Care Planning KW - Emergency medicine KW - Informed consent KW - Intensive care KW - Shared decision making JF - Der Anaesthesist JO - Anaesthesist N2 - Despite the availability of the instruments of advance directives, power of attorney and healthcare proxy, the patient's preferences for life-sustaining medical treatment in a specific situation often remain unknown. The aim of the systemically designed German Advance Care Planning (ACP) program is the reflection, documentation and implementation of patients' preferences regarding future medical treatment in case they are incapable of legally binding decision-making. A specially trained ACP facilitator initially supports the verbalization of the attitudes towards life, severe illness and death on an individual level. Based on these principal views, concrete preferences on how to be treated under defined medical circumstances can be discussed and documented in an advance directive. This includes the three scenarios medical emergency, inpatient hospital treatment in situations with decisional incapability of unknown duration and the situation of permanent cognitive impairment. Through cautious, nondirective conversational techniques in the sense of shared decision-making, the person is enabled to reflect and decide well-informed according to the informed consent standard. All persons participating in decisions regarding future medical treatment, especially future surrogate decision makers, are involved in the process as early as possible. A systematic institutional and regional implementation of the concept is necessary to ensure that the carefully assessed and documented preferences of the patients will be known and honored. The new German § 132g of the Social Code Book V (SGB V) enables institutions for long-term care and for the care of disabled persons, to offer facilitated ACP to all residents at the expense of the statutory health insurance funds. An increased dissemination of this concept is to be expected. SN - 1432-055X UR - https://www.unboundmedicine.com/medline/citation/31820016/[Advance_Care_Planning-further_development_of_the_patient_advance_directive_:_What_the_anesthetist_must_know] L2 - https://dx.doi.org/10.1007/s00101-019-00697-2 DB - PRIME DP - Unbound Medicine ER -
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