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Advance care planning imperative: High-quality patient-centred goals of care
  1. Amy Allen Case1,
  2. Andrew S Epstein2 and
  3. Jillian L. Gustin3
  1. 1 Supportive and Palliative Care, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
  2. 2 Memorial Sloan Kettering Cancer Center, New York, New York, USA
  3. 3 Division of Palliative Medicine, Arthur G James Cancer Hospital and Richard J Solove Research Institute, The Ohio State University College of Medicine, Columbus, Ohio, USA
  1. Correspondence to Dr. Amy Allen Case, Supportive and Palliative Care, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA;{at}


Advance care planning (ACP) discussions aim to ensure goal-concordant care for patients with serious illness, throughout treatment and especially at the end of life. But recent literature has forced the field of palliative care to wrestle with the definition and impact of ACP. Are ACP discussions worthwhile? Is there a difference between ACP discussions early in a patient’s illness versus discussions occurring later when a concrete medical care decision must be made? Here, we identify elements needed to answer these questions and describe how a multisite initiative will elucidate the value of discussing and documenting what matters most to patients.

  • Cancer
  • Supportive care
  • Communication
  • End of life care
  • Quality of life

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  • Contributors All authors, AAC, AE and JG, contributed equally to this work including conception, planning, research, manuscript writing and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.