• J Palliat Med · Dec 2004

    Review

    Three principles to improve clinician communication for advance care planning: overcoming emotional, cognitive, and skill barriers.

    • Joseph S Weiner and Steven A Cole.
    • Long Island Jewish Medical Center, New Hyde Park, New York, USA. weiner@lij.edu
    • J Palliat Med. 2004 Dec 1;7(6):817-29.

    BackgroundMedical care of patients with life limiting illness remains fraught with serious deficiencies, including inadequate advance care planning, delayed hospice referral, and continued delivery of aggressive treatment that is overtly counter to patients' preferences.ObjectiveThis paper describes clinicians' emotional, cognitive, and skill barriers to shared decision-making with seriously ill patients and their loved ones.DesignThematic literature review.ResultsBased on a literature review, as well as clinical and educational experience, we articulate three principles to address these barriers and guide future professional communication training for advance care planning.ConclusionsWe argue that these barriers must be overcome before deficiencies in end-of-life care can be fully ameliorated.

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