Advance end-of-life treatment planning: A research review

The year 1996 marks the fifth anniversary of the federal Patient Self- Determination Act. The Patient Self-Determination Act required hospitals, nursing homes, and health plans to ask whether patients have advance directives and to incorporate them into the medical record. A 'living will' is an advance directive by which a person tells caregivers the circumstances in which life-sustaining treatment is to be provided or forgone if the patient is unable to communicate. A 'durable power of attorney for health care' enables one to designate a person to speak on his or her behalf if the author loses decision-making capacity. 'Advance planning' is the process of reflection, discussion, and communication of treatment preferences for end- of-life care that precedes and may lead to an advance directive.