title: Advance care planning: re-visioning our ethical approach.
abstract: This qualitative study explored the applicability and usefulness of a promising advance care planning (ACP) intervention and examined the ACP process. Nine dyads (patients newly diagnosed with advanced lung cancer and a family member) participated in the ACP intervention, with evaluative interviews at 3 and 6 months after the intervention. All interviews were recorded, transcribed verbatim, and analyzed using constant comparison. The process was found not to be one of preparing a substitute decision-maker to speak for oneself and direct health care at a time when one is incapacitated; rather, the families engaged in a deeply relational process where meaning, values, and preferences were negotiated in conversation. ACP is theoretically rooted in a traditional notion of patient autonomy that is not aligned with the relational process that unfolded in this study. An approach that embraces relational autonomy is more congruent and provides a stronger foundation for meeting the needs of families.
authors: School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada.
authors: Carole A
authors: CA
authors: Robinson
mesh_terms: D032722:Advance Care Planning; D002170:Canada; D004993:Ethics, Nursing; D005610:Freedom; D006801:Humans; D008175:Lung Neoplasms / Q000451:nursing