[10] Advance care planning aims to allow people to live well, and when death approaches, die in accordance with their personal values.
Federal and state legislation in the US,[17] Australia,[18] Canada[19] and the UK[20] supports the right of patients to refuse unwanted medical treatments.
People can also express their preferences through written advance directives or by advising their appointed substitute decision maker about their wishes for when they are unable to make or communicate these decisions/wishes themselves.
[21] Whilst different approaches are emerging, there has been low uptake of digital advance care planning in countries including the UK.
These are: Findings from a systematic review suggest the value and importance that various types of decision aids have for patients to use and help clarify their goals.
In the absence of a statutory document the substitute decision maker may be a "person responsible" as listed in order of authority in legislation.
[25] A substitute decision maker can be chosen by an individual following completion of relevant paperwork, can be assigned to the person by law in the absence of a chosen substitute decision maker (e.g. family member or carer), or can be appointed for the person (e.g. guardian appointed by a guardianship tribunal).
[48] Inclusion of a doctor in the completion of an advance care directive will assist in ensuring that an individual's wishes are clear and written in a manner that is easy for substitute decision makers and/or medical staff to interpret and follow them in the future.
Where the patient's advance decision relates to a refusal of potentially life-saving or life prolonging treatment, this must be recorded in writing and witnessed.
An example of an ADRT is the national form and guidance published by NHS Wales on their Advance and Future Care Planning site.
[4] Advance care planning (ACP) may help to increase documentation by medical staff regarding discussions with participants, and improve an individual's depression.
[51] Advance care planning can effectively support older people with frailty to express what kind of healthcare they would prefer in the future.