Although I haven’t yet had a chance to read Dr. Lakin’s research study from JAMA referenced in this article (but I certainly plan to!), this summary from Paula Span provides food for thought.
Here is a comment I posted, but is still waiting for approval from NYTimes.com. But here it is in the meantime:
Thank you Ms. Span for another article on the extremely important topic of advance care planning. I work in the ICU and in my experience, very few patients have documented end of life preferences when they arrive in the ICU despite having chronic or even end stage diseases for many many years. This has to change!
Paula Span, NYTimes.com, The New Old Age
Although I haven’t yet read Dr. Lakin’s research study, it strikes me that it’s not important not only to encourage doctors to document an end of life care plan, but also to make sure that it is accurate and not simply a default, which is often “do everything”.
There are some great resources out there for patients and families to use to embark on these difficult conversations. Personal stories are a wonderful way to get information, and the work that the Conversation Project does is excellent. Also, the Last Wish Compass (www.knowyourwishes.com/Compass.html) is a brief discussion guide that helps patients consider important issues to communicate with their families and doctors. Dr. Lakin’s work is exciting in that it suggests increased awareness does make a difference.
-Lauren VanScoy, MD
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