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PP04.004 Effective dialogue about individualized advance care planning in community through humanistic and artistic activities
  1. Wan-Ting Hsieh
  1. Director of Department of Palliative Medicine, Chi-Mei Medial Center, Tainan City, Taiwan


Background Patient Right to Autonomy Act was valid in 2019 in Taiwan and over 40000 documents of advance directives(AD) with legal-bound were registered until 2022. However, these ADs looked similar on everyone’s medical option and failed to demonstrate one’s unique preference and special value. This study aims to reveal the fact to the public.

Methods We use phenomenology to proceed our study. We held series of activities called ‘□□□□□’(Good death, Peace and safe) and recruited people from social media. The process is a delightful physical-psychological experience such as enjoy a tea banquet or making a aromatic candle, followed by thinking about five important terms in palliative care, ACCEPT, RECONCILIATION, CONNECTION, POWER, COMFORTABLE, then write down their own □□□(the letter of final wish) contained four domains: body, mind and spirit, relationship, and finance. We collect the letters for an exhibition which will be held in 2023 summer(we expect to collect 100 letters).

Results 11 people attended our activities currently and wrote down their □□□. All of them showed strong wills of discussing their end-of-life issues and gave feedback to us that our activities help them to clarify the values and instruct them to prepare advance directive naturally. Before entering a clinic to discuss with advance care planning consultation team and writing down the legal-bound AD, they were well prepared and even planed more beyond the information shown on AD.

Conclusion People’s good death wishes are always impractical and far from the real clinical situations. AD is just a collection of choices of life-sustaining treatment but unable to help people to dig out their individualized preference and demonstrate their autonomy. Our study fulfills two goals: first, reveal the limit of the law and second, enhance the importance of the humanistic dialogue lead by experienced professionals before writing down AD.

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