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James Beattie1 is correct that effective communication should begin at the earliest opportunity, usually at the first consideration of using a life-sustaining medical device (LSMD). Some patients will want to discuss all possible outcomes including withdrawal of the LSMD. Some patients will go further and choose to make advance statements describing their preferences and wishes, beliefs and values, or choose to make an advance decision …
Collaborators National End of Life Care Programme.
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.