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The scurrilous investors in Ankh-Morpork's communications system were an obvious attack on a denationalised rail service, cutting corners and endangering lives, all the while offering meaningless platitudes about "improved directives" and apologies for the inconvenience of being killed.
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Some newer ACP approaches, which have improved directive completion, include software-guided discussion [ 13] and facilitated discussion by members of the healthcare team such as social workers or clergy [ 14, 15].
"Through some hard negotiation we very much improved the directive.
Increased data on the probability of ETT complications will improve advance directive decision making by allowing quality of life to be discussed in the event of survival after intubation.
In the future, criteria should be harmonised and improved in the different directives and regulations and field data should be more intensively used for assessing the bioaccumulation potential of chemicals.
One of the participants expressed the hope that public health interventions could be improved by following European directives (Table 2, Quote 2c).
The mandatory refund amount for transfers that are debited from the sender's account but not credited to the receiver's account, namely ECU 12 500, is a compromise that will have to be improved on when the directive is reviewed.
Such an approach intentionally contrasts with much patient safety research which assumes that safety is achieved and improved through top-down policy directives.
The European Commission launched a consultation last autumn soliciting for feedback on how the PSI Directive could be improved.
Meanwhile, the third improved version of the EU Directive inspired by the incident has been implemented.
A systematic review of 55 studies assessing ACP interventions with older adults found that patients preferred to discuss future health care plans with family rather than healthcare providers, complete informal (35.9%) rather than formal (22.7%) plans, and advanced directive completion rates improved when professional teams provided assistance across multiple sessions [ 22].
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