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Advance Care Planning: “It Always Seems Too Early, Until It’s Too Late”

Which of the following statements do you believe to be true?

  • Doctors and nurses should do everything possible to save the life of a patient in all circumstances.
  • Sometimes there are circumstances in which a person should be allowed to die.

This question was posed as part of a Pew Research Center study in 2013. At that time, 31% of Americans who participated believed that everything possible should be done in all circumstances while 66% believed that sometimes a person should be allowed to die.

Now consider yourself as the patient in these two statements. Does your viewpoint change or remain the same?  Would you want someone who held the opposite viewpoint from your own making health care decisions for you?  If you haven’t taken the time to consider advance care planning, this could possibly happen.

The same Pew Research Center study noted above also found that for adults of all ages, only 37% have given extensive thought to their wishes for medical treatment near the end of life. National Healthcare Decisions Day, which was held on April 16th, is part of an effort to educate and empower the public about the benefits and importance of this type of planning.  The theme for this year’s outreach is the title of this article.

Advance care planning is important because personal beliefs about illness, disability, quality of life, and the role of medical care vary widely. Unfortunately, at some point in their lives, circumstances may arise for individuals in which they are not able to understand their situation or voice an opinion about desired care and treatment.  The right of self-determination is a highly- valued concept in our society, and advance care planning allows individuals to think through potential life scenarios and formulate personal guidelines for care while they still have capacity.

For these guidelines to be effective, however, they must be communicated to others.  This can be accomplished by putting them into writing via official legal documents, a personal letter, or by using various forms which are available through organizations which promote advance care planning.  Perhaps even more important than having this information in writing is to have conversations about your wishes with loved ones.  Health care professionals will look to your family members for assistance with care decisions if you are unable to participate yourself.  Uncertainty and stress about these decisions will be greatly reduced if you have previously explained your feelings and preferences about care.  Formal advance care planning also allows for the designation of a healthcare agent to act on your behalf when gray areas arise which might not have been anticipated and discussed.

It is easy to believe that such a situation may be far in the future, or may never happen to you. Although it may seem too early, none of us can be sure about what tomorrow may bring. Delaying advance care decisions until it is too late takes away your power to act for yourself, and may lead to undesirable consequences for yourself and additional grief for your loved ones.  For additional resources, visit the National Healthcare Decisions Day website at, or call Keystone Elder Law at 717-697-3223.

Karen Kaslow, RN