Article Text
Abstract
Background So far, there is no legal regulation of advance directives (ADs) in Italy. Nevertheless, there’s an increasing demand among the population to document preferences regarding future medical treatment. Also, health care professionals request more expertise in eliciting and respecting their patients’ wishes in order to improve end-of-life decision-making. Therefore, the Provincial Bioethics Committee of South Tyrol (Northern Italy) started an advance care planning (ACP) project in 2009 in cooperation with the provincial Association of Nursing Homes, the Caritas Hospice movement, the South Tyrolean Healthcare Provider and the General Medical Council of Bolzano.
Aims To enable health professionals to offer assistance to individuals in developing and articulating their wishes regarding future medical treatment and to ensure that the resulting plans are available and honoured reliably in the region.
Implementation process The multifaceted ACP implementation included ACP-training courses for health professionals, information brochures for citizens and health professionals with an exemplary AD form, practice guidelines about “ADs in end-of-life decision making” and “Artificial Nutrition and Hydration”, conferences and public lectures, complemented with information in the local mass media and on the Bioethics Committee’s website.
Results/discussion Approximately 18.000 ACP-brochures have been distributed. Many people ask for information and advise about ADs, an increasing number of general practitioners offer AD-consultations to their patients. In September 2014 a group of General Practitioners started a local ACP-project in the Venosta valley to further promote ACP in this part of South Tyrol. We will discuss successes and challenges of the – to our knowledge – first regional ACP implementation process in Italy.