Advance care planning (ACP) has emerged during the last 30 years as a potential response to the problem of low-value end-of-life care. The assumption that ACP will result in goal-concordant end-of-life care led to widespread public initiatives promoting its use, physician reimbursement for ACP discussions, and use as a quality measure by the Centers for Medicare & Medicaid Services, commercial payers, and others. However, the scientific data do not support this assumption. ACP does not improve end-of-life care, nor does its documentation serve as a reliable and valid quality indicator of an end-of-life discussion.
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Based on this commentary, would you recommend that palliative care advocacy groups, such as the Center to Advance Palliative Care (CAPC), which Dr. Meier founded and lead for many years and which continues to advocate for advance care planning (ACP) on its website (1), cease promoting ACP?
CAPC and other similar palliative care advocacy groups helped spearhead the widespread adoption of ACP, including its use as a quality indicator, so I believe, given your present commentary, that these groups should now help lead the charge to "disinherit" ACP. What do you think?
Morrison RS, Meier DE, Arnold RM. What’s Wrong With Advance Care Planning? JAMA. 2021;326(16):1575–1576. doi:10.1001/jama.2021.16430
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