Patients did not have an advance directives document, nor were their treatment preferences documented during the last hospitalization (0,5 and 1,62 %, respectively).
In the years after Quinlan, judicial opinions and legislation, combined with ethics analyses and clinical guidelines, succeeded in establishing patients' rights to refuse unwanted treatment and their option to use advance directives to document treatment preferences in advance of a medical crisis.
Advance Care Planning (ACP) is an emerging strategy to ensure that well-reflected, meaningful and clearly documented treatment preferences are available and respected when critical decisions about life-sustaining treatment need to be made for patients unable to consent.
Patients may also wish to document specific treatment preferences for cardiopulmonary resuscitation and prolongation of life.
32 It was used to document specific treatment preferences of patients and their surrogates' understanding of what the patient would want.
Advance care planning aimed to assist patients to reflect on their goals, values, and beliefs; to consider future medical treatment preferences; to appoint a surrogate; and to document their wishes.
Standardized forms should provide space for free text entries in all sections of the documents, ask specifically for treatment preferences of diagnosed diseases in critical and/or end-of-life situations.
Nintedanib, a multi-tyrosine kinase inhibitor, was used in a small subset of patients, which reflects the treatment preferences in specialist centres that were allowed to document patients in the open-label, nonblinded periods of clinical studies.
29 Five Wishes © (Towey and Aging with Dignity) is a legal document that facilitates expression of treatment preferences, if they were unable to communicate their wishes and includes the selection of a surrogate decision-maker.
These measures included the number of visits by the facilitator to conduct ACP, the total time required to conduct ACP, the type of documents completed, the patient's treatment preferences (if known) and whether an interpreter was used.
In this simple survey we documented the treatment received by 415 people with chronic knee pain, their treatment preferences and rationale for these preferences, and matched treatment received and preferences against the recommendations of the three most important clinical guidelines for management of knee pain/osteoarthritis [ 3, 13, 14].
