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Schmitten, J. in der; Nauck, F. und Marckmann, G. (2016): Behandlung im Voraus planen (Advance Care Planning): ein neues Konzept zur Realisierung wirksamer Patientenverfügungen. In: Zeitschrift für Palliativmedizin, Bd. 17, Nr. 4: S. 177-193

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Abstract

Advance Care Planning (ACP) is now also established in Germany as a new concept to realise effective advance directives. Accordingly, individuals are regularly invited to develop and document their preferences for possible future medical care in a professionally facilitated communication process. At the same time, all relevant health care institutions and lead actors are invited in a systematic regional approach (change management) to participate, to inform and train staff at various levels, and to implement the necessary structures so that the resulting care plans are reliably available and respected. This paper outlines the ethical foundations of ACP and why this new approach became necessary, explains its basic concept, and reports major international ACP developments. The required elements of an ACP program and the contents of the facilitated communication process are presented in detail. Advance planning for emergency situations is covered as well as planning for individuals who have no decision-making capacity (ACP by proxy). The article closes with directions for the regional implementation of ACP programs, and an introduction into the new 132g (Social Code Book V) which effectuates, probably from 2017 on, reimbursement of chronic care institutions that participate in regional ACP programs and offer facilitated ACP to their residents.

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