Introduction
This topic covers advance care planning as an ongoing process and advance directives as the documents that record a person's future treatment wishes. It explains how these tools protect autonomy when a patient later loses decision-making capacity, and how doctors apply them in clinical practice.
Definitions
Advance care planning (ACP) is a process in which a person with capacity reflects on their values, goals and acceptable limits of treatment, discusses them with family and doctors, and records their wishes for a time when they may be unable to decide. It is a conversation first and a document second.
An advance directive is a recorded statement of a person's preferences about medical treatment that applies when they lack capacity. The main forms are compared below.
Ethical basis
Advance directives rest mainly on respect for autonomy: a capable person's decisions about their own body remain binding when they can no longer express them. They also serve beneficence and non-maleficence, because they help avoid burdensome treatment the patient would not want. Informed consent (topic 2) governs current decisions; advance planning extends the same principle into the future.