Decision making about end of life care: Advance directives, durable power of attorney for healthcare, and talking with patients with heart disease about dying

Craig Tanner, Craig Tanner

Research output: Chapter in Book/Report/Conference proceedingChapter


Advancing technology has complicated decision making about end of life care. Advance directives arose as a legal response to concerns about patients receiving unwanted interventions near the end of life. Healthcare advance directives and durable power of attorney for healthcare held the promise of controlling medical care at the end of life. This promise has not been realized. All clinicians providing care to patients with heart failure or other life-limiting illnesses should develop a set of communication skills to discuss goals of care, resuscitation preferences and wishes for end of life care. Patient centered communication skills and empathetic response to emotion are the foundational tools for addressing these issues. Newer models of advance care planning are more based on communication between providers, patients and families than on legal documents The POLST paradigm represents an important innovation in allowing patients to document their preferences for care in a portable document which is a legal physician order.

Original languageEnglish (US)
Title of host publicationEnd-of-Life Care in Cardiovascular Disease
PublisherSpringer-Verlag London Ltd
Number of pages12
ISBN (Electronic)9781447165217
ISBN (Print)9781447165200
StatePublished - Jan 1 2015



  • Advance care planning
  • Advance directives
  • Communication skills
  • Durable power of attorney for healthcare
  • Empathy
  • End of life
  • Living will
  • Palliative care
  • Power of attorney
  • Resuscitation

ASJC Scopus subject areas

  • Medicine(all)
  • Social Sciences(all)
  • Psychology(all)

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