Advance care planning
This chapter, written for undergraduate medical students and post-graduate doctors in training, presents information on advance care planning in a general practice setting. It presents the case of a 72-year-old retired builder who was visited by a general practitioner at home to write an anticipatory care plan. Two months earlier, the patient had a severe exacerbation of chronic obstructive pulmonary disease (COPD) with several admissions to the local Accident and Emergency Department (A&E) and the assessment ward within a few days. Key questions prompt the student to evaluate the patient, and reach a decision regarding their condition and the possible treatment plan. The chapter explains whether the patient a right to refuse a 'do not attempt cardio-pulmonary resuscitation' (DNACPR) order and also how the general practitioner should respond to the patient's fears that he will not be treated properly once he has a DNACPR order in place.