Larry A. Allen|Lynne Warner Stevenson|Kathleen L. Grady|Nathan E. Goldstein|Daniel D. Matlock|Robert M. Arnold|Nancy R. Cook|G. Michael Felker|Gary S. Francis|Paul J. Hauptman|Edward P. Havranek|Harlan M. Krumholz|Donna Mancini|Bárbara Riegel|John A. Spertus
Decision Making in Advanced Heart Failure
American Heart Association|American Heart Association|American Heart Association|American Heart Association|American Heart Association|American Heart Association|American Heart Association|American Heart Association|American Heart Association|American Heart Association|American Heart Association|American Heart Association|American Heart Association|American Heart Association|American Heart Association
hared decision making advanced heart failure become challenging crucial duration disease treatment options increasedhighquality decisions chosen medically reasonable options aligned values goals preferences informed patientthe top 10 things know decision making advanced heart failure care listed table 1 shared decision makingproviders ethical legal mandate involve patients medical decisionsshared decision making recognizes complex tradeoffs choice medical care 1 shared decision making also addresses ethical need fully inform patients risks benefits treatments 2 setting multiple reasonable options medical care shared decision making involves clinicians working patients ensure patients values goals preferences guide informed decisions right individual patientgrounded ethical principle autonomy 3 judicial decisions eg cruzan v missouri department health 4 legislative actions eg patient selfdetermination act 5 repeatedly affirmed rights patients duly appointed surrogates choose medical therapy among reasonable options 6the formal process informed consent procedural interventions embodiment concept underscores clinicians obligation ensure patient opportunity informed 3an informed patient one aware diagnosis prognosis nature proposed intervention risks benefits intervention reasonable alternatives associated risks benefits 7a major purpose highfunctioning healthcare system provide resources activated informed patient engage productive discussions proactive prepared healthcare team 8hared decision making moves beyond informed consentit asks clinicians patients share information work toward patientcentered decisions aboutthe american heart association makes every effort avoid actual potential conflicts interest may arise result outside relationship personal professional business interest member writing panelspecifically members writing group required complete submit disclosure questionnaire showing relationships might perceived real potential conflicts interest