Should research be part of advance care planning 英文参考文献.docVIP

Critical Care February 2005 Vol 9 No 1 Easson Commentary Should research be part of advance care planning? Alexandra M Easson Lecturer, University of Toronto, Department of Surgical Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada Corresponding author: Alexandra M Easson, Easson.Alexandra@uhn.on.ca Published online: 16 December 2004 This article is online at /content/9/1/10 ? 2004 BioMed Central Ltd Critical Care 2005, 9:10-11 (DOI 10.1186/cc3029) Abstract Advance care planning is a process to help people to formulate and communicate their preferences regarding future care during critical illness. Reviews of the advance care planning process in its current form have been disappointing. Improvements in care at the end of life and palliative care are necessary for the provision of modern medical care. Medical research has led to many improvements at the physiological and technological levels. It is only by applying the same rigour of scientific study and research ethics that improvements in the advance care planning process can be made. Keywords advance care planning, critical illness, palliative care, research ethics Advance care planning is a process to help people formulate and communicate their preferences regarding future medical care in anticipation of a time when they are unable to express those preferences because of incapacity due to critical illness or injury [1,2]. In our current medical system, the result of these deliberations is generally expressed when the patient prepares an advance directive. This directive, either oral or written, may be an attempt to predict and direct care in the event of specific and unfortunate future situations (e.g. it may pertain to whether life support should be prolonged) or it may designate a specific person to speak on the patient’s behalf. The premise of this process is that when the patient can no longer make decisions, the physician who is caring for them will be able to use this d