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Editorials |

Time To Move Advance Care Planning Beyond Advance Directives

Henry S. Perkins, MD
Author and Funding Information

Affiliations: San Antonio, TX 
 ,  Dr. Perkins is Interim Director, Center for Ethics and the Humanities in Health Care at The University of Texas, The University of Texas Health Science Center at San Antonio.

Correspondence to: Henry S. Perkins, MD, Department of Medicine, The University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78229-3900; e-mail: perkins@uthscsa.edu.



Chest. 2000;117(5):1228-1231. doi:10.1378/chest.117.5.1228
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Patients fear losing their lives to the medical system. They dread being trapped in insensitive medical institutions, tethered to inhumane machines, robbed of personal privacy, and subjected to the accompanying indignities. Driven by this specter, many patients want to make decisions to govern their future treatment—a process called advance care planning. For over 30 years, the best-known means of advance care planning has been advance directives. By signing these legal documents, patients can request or refuse specific treatments and can choose proxies for times of future incapacity. Advance directives promise what many patients crave most for the end of life—control over treatment.1

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