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Comment & Response
June 2018

Further Considerations Concerning Advance Care Planning in Medical Practice

Author Affiliations
  • 1Department of Internal Medicine, Morehouse School of Medicine, Atlanta, Georgia
JAMA Intern Med. 2018;178(6):867. doi:10.1001/jamainternmed.2018.1772

To the Editor We read with great interest the Research Letter by Lee et al1 published in a recent issue of JAMA Internal Medicine. The authors note that the assistance of a qualified chaplain to conduct advance care planning is a feasible way to address and complete advance directives.

Of interest is that these conversations were initiated in the physician’s office. Various studies2-4 have noted that the setting in which this important discussion occurs may affect the outcome. For example, Bern-Klug and Byram2 noted that a higher percentage of individuals had discussed their end-of-life wishes with a lawyer in comparison to a physician. This interesting finding may be owing to a number of factors including the association of advance directives and living wills with legal documents. However, it may also be that a lawyer’s office feels more private instead of a physician’s office, which may have many patients in the waiting room.

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