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P11 Ideal and realistic advance decisions
  1. WT Hsieh
  1. Chi-Mei medical center, Tainan, Taiwan


Background The Patient Autonomy Law was passed on December 18, 2015 in Taiwan and will be valid on January 6, 2019. Advance care planning is the legal duty before signing an advance decision. As a medical center participating in the pilot study, we collect 99 advance decisions made after advance care planning. However, the 99 advance decisions looked the same because all the people refuse life-sustaining treatment and artificial nutrition and hydration. It’s revealed a question that advance decision is too vague to be implemented under clinical scenario. This study will discuss how to make advance decision more useful in the clinical situations.

Method Analysis the nature of advance decision by the factors which influence one’s decision-making process.

Results People tend to express a vague value rather than a precise decision about medical choices. Previous decisions may not be accurately used in complex and specific clinical situations. The decision supposed to be made rationally but patient has the emotional needs during the process of receiving information and making decisions. If the patient’s mental capacity declined, whether the patient’s critical interest is still the same is argued. Conflicts were found between the personality identity and the experiential interest sometimes.

Conclusion Value-oriented advance decisions are intended to be acquired ideally. However, advance decisions are not a history book of value. It is simply a plan before death, a collection of treatment preference. Therefore, advance decisions need to be translated, weighed and clarified by health care providers while implementation.

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