Background The “right to grant and register an advance directive” has spread in Spain’s health care legislation. Reality check: documents are completed by less than 1% of the population. Having ACP philosophy widespread elsewhere, this seems a rather meager approach that, additionally, does not sympathize with the way, we, human beings suffer, endure and face illness.

Method Intellectual journey, rationale and roadmap for a new twist in Spain’s theoretical, ethical and policy development.

Results Few healthcare administrations and some individual experiences in Spain are promoting ACP implementation into public health care systems. In 2017, the “Spanish Working Group on Shared Care Planning” (GET-PCA in Spanish) was build up with the conviction that what could be done to take advantage of our strengths as a National Health System and a caring Mediterranean culture was midwifing shared-decision making (SDM) for current care together with the pursue of ACP for future care in what we named as “shared care planning” (SCP).

GET-PCA defines SCP as “a deliberative, relational and structured process that facilitates reflection and understanding of illness’ and care’s experiences, among all involved, focusing on each person facing a disease trajectory, to identify and express their preferences and expectations within their context of care. Its goal is to promote SDM in relation to current context and ACP to future care challenges, such as when the person might not be competent to decide for herself.”

Conclusion SMD matching ACP may save the day for Spain. Best of both worlds: welcome shared care planning!