BMJ  2006;333:868-869 (28 October), doi:10.1136/bmj.39009.569861.80

Editorial

Advance care planning in primary care

Uncomfortable, but likely to engender hope rather than dispel it

The first 150 words of the full text of this article appear below.

Of the various trajectories of physical decline, organ failure is often the most difficult to plan for in advance because of its unpredictability.¹ The qualitative study by Davison and Simpson in this week's BMJ challenges the notion that early discussion of planning for the end of life will destroy hope rather than create it. Rather, it allowed patients dying of end stage renal failure and their carers to reflect on and reorient their aspirations.² A wealth of evidence indicates that many elderly patients want to discuss these issues with their healthcare professionals, but this rarely happens even when (as in the United Kingdom) continuity of care with a trusted general practitioner is available.^{3 4} The main barrier is probably doctors' reluctance to raise the issue of planning for death because of the largely unfounded fear of destroying hope.

Advance care planning is practised in Australia, Canada, and the United States.^5-7 . . . [Full text of this article]

Primary Palliative Care Research Group, Division of Community Health Sciences: General Practice Section, University of Edinburgh, Edinburgh EH8 9DX
(Scott.Murray@ed.ac.uk)

Primary Palliative Care Research Group, Division of Community Health Sciences: General Practice Section, University of Edinburgh, Edinburgh EH8 9DX

NHS End of Life Care Programme England, John Taylor Hospice, Birmingham B24 0DF

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Never say die?

Stephen R Workman
bmj.com, 27 Oct 2006 [Full text]

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