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January 11, 2021

Advance Care Planning and the Cost of Pragmatism

Author Affiliations
  • 1Department of Medicine, University of California, San Francisco
  • 2Editorial Fellow, JAMA Internal Medicine
  • 3Department of Medicine, Duke Clinical Research Institute, Durham, North Carolina
  • 4Associate Editor, JAMA Internal Medicine
  • 5Deputy Editor, JAMA Internal Medicine
JAMA Intern Med. Published online January 11, 2021. doi:10.1001/jamainternmed.2020.5935

Advance care planning (ACP) is a stepwise process that addresses patient preferences for advance directives, durable power of attorney, and end-of-life care. These discussions often lead to higher-quality, goal-concordant care for patients.1 Yet, ACP rarely occurs in the ambulatory care setting.2 Moreover, current approaches to ACP often fail to engage patients and their families or are not well integrated into clinician workflow.3

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