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Advance Care Planning (ACP) vs. Advance Serious Illness Preparations and Planning (ASIPP)

机译：先进保健规划（ACP）对阵推进严重的疾病准备和规划（ASIPP）

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摘要

COVID-19 has highlighted the reality of an impending serious illness for many, particularly for older persons. Those faced with severe COVID-19 infection or other serious illness will be faced with decisions regarding admission to intensive care and use of mechanical ventilation. Past research has documented substantial medical errors regarding the use or non-use of life-sustaining treatments in older persons. While some experts advocate that advance care planning may be a solution to the problem, I argue that the prevailing understanding and current practice of advance care planning perpetuates the problem and results in patients not receiving optimal patient-centered care. Much of the problem centers on the framing of advance care planning around end of life care, the lack of use of decision support tools, and inadequate language that does not support shared decision-making. I posit that a new approach and new terminology is needed. Advance Serious Illness Preparations and Planning (ASIPP) consists of discrete steps using evidence-based tools to prepare people for future clinical decision-making in the context of shared decision-making and informed consent. Existing tools to support this approach have been developed and validated. Further dissemination of these tools is warranted.
机译：Covid-19强调了许多人的即将发生严重疾病的现实，特别是对于老年人来说。面临严重的Covid-19感染或其他严重疾病的人将面临有关深入照顾和使用机械通气的决定。过去的研究已经记录了关于老年人使用或不使用寿命治疗的大量医疗误差。虽然一些专家倡导提前关怀规划可能是解决问题的解决方案，但我争辩说，现行的理解和目前的经济规划的实践使得不接受最佳患者中心护理的患者的问题和结果。在终身关心结束时，缺乏决策支持工具的框架，以及不支持共同决策的语言不足，缺乏使用决策支持工具的框架。我需要一种新的方法和新的术语。提前严重的疾病制定和规划（ASIPP）包括使用基于循证工具的离散步骤，为在共享决策和知情同意的情况下，为未来的临床决策制定人员。已经开发并验证了支持这种方法的现有工具。有必要进一步传播这些工具。

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