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Invited Commentary
November 26, 2018

Preparing Surrogates for Complex Decision Making: The Often Neglected Piece of the Advance Care Planning Equation

Author Affiliations
  • 1Division of Geriatrics, Department of Medicine, University of California, San Francisco
  • 2San Francisco Veterans Affairs Health Care System, San Francisco, California
  • 3Innovation and Implementation Center for Aging and Palliative Care (I-CAP), Division of Geriatrics, Department of Medicine, University of California, San Francisco
JAMA Intern Med. 2019;179(2):268-269. doi:10.1001/jamainternmed.2018.5280

Advance care planning (ACP) has been defined as a process that supports individuals and patients in defining their values, goals, and preferences for future medical care and sharing that information with others.1 The main goals of ACP include preparing patients for complex medical decision making and ensuring that they receive medical care aligned with their goals in case of decisional incapacity. If patients lose decision-making capacity, surrogate decision making often falls to close family members or friends. However, in many instances, these family members and friends do not know that they were named on advance directive forms or that they may be thrust into complex surrogate decision making.2

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