Advance care directives

Does advance care planning work? There's controversy swirling around the question and we shed some light on the debate with two leading physicians with different views.

Daniela Lamas, M.D., is a critical care physician at Brigham and Women's Hospital in Boston and a faculty member at the Harvard Medical School. She's also a frequent opinion writer for The New York Times. The paper published her piece, "When Faced With Death, People Often Change Their Minds," earlier this year.   

"We need to shift the focus from talking to healthy people about what would happen should they stop breathing during a routine procedure, and toward improving conversations with people who are already seriously ill," Dr. Lamas wrote.

Her op-ed piece comes on the heels of an essay the Journal of the American Medical Association published a few months earlier, "What's Wrong With Advance Care Planning?" by Drs. Sean Morrison, Diane Meier, and Robert Arnold, which argues that advance care planning has failed to accomplish its goals of aligning care and improving communication at the bedside.

Joining Dr. Lamas in conversation is Ira Byock, M.D., a palliative physician, author, longtime advocate for advance care planning, and the founder of the Providence Institute for Human Caring, where this podcast is produced. 

Dr. Byock holds that while there’s dire need to redesign advance directives, providers should talk with patients about who they trust to speak for them and their general healthcare goals — optimally long before onset of a medical crisis. 

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The podcast producers are interested in hearing from providers with questions or suggestions for an upcoming webinar on BEST PRACTICES FOR SOCIAL MEDIA USE FOR HEALTHCARE PROFESSIONALS. Have a story to share with us? Have suggestions? Write to us at HearMeNowStories@providence.org or leave a voicemail message on +1 424-212-5436. And thanks!

CONTRIBUTORS

• Seán Collins
• Ira Byock MD
• Daniela Lamas MD

KEYWORDS

• decision making
• communication
• advance care planning
• health proxy
• advance directives
• end of life decision-making
• goal-aligned care
• family decision making