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Talking Advance Care with Tanja Krones

19 Apr 2016, by Informa Insights


Discussing legal, ethical and practical issues and steps towards best practice of ACP is day to day business for the Head of Clinical Ethics for the University Hospital Zürich, PD Dr. Tanja Krones. As we draw closer to the Advance Care Planning Conference (2-3 May) in Sydney, we were lucky enough to have Tanja answer a few preview questions to give us a taste of what’s to come at the event:

What have been some of the highlights of your career so far, in particular in your work around advance care planning?

Well highlights in a career are hard to define, sometimes small things are more impressive than “big ones”. But with regard to ACP I am particularly proud that we have not only recently implemented an office coordinating  advance care planning in my hospital, but also discussing a nationwide strategy on advance care planning in Switzerland coordinated by the ministry of health, an initiative also triggered by our research.  This is really a huge step forward in my country.

You are presenting the keynote opening address at the conference where you will share the first results of the Zurich MAPS TRIAL. Without giving too much away about your upcoming presentation, are you able to explain some of the best evidence based patient decision aids as a result of your TRIAL?

I think that most importantly, our work is part of a current development, two important patient /consumer oriented movements coming together: the shared decision making movement- also integrating medical and value knowledge of evidence based decision aids into routine care and advance care planning, supporting people in decision making for future medical care.  One of the most important and- to my experience also impressive reactions comes from explaining via an evidence based decision aid, what resuscitation is and what it is not.

You are also presenting the Post-Conference Half-Day Workshop on Wednesday the 4th of May. The workshop will discuss ethical concepts and practical experiences for patients not fully capable or incapable of decision making. What are some of the key ACP strategies delegates can expect to take away to use for patients with deteriorated delusional capacity?

First of all the most important key issue is awareness building. Most ACP has focussed on patients being fully capable of decision-making. Also legally, Advance directives are conceptualized as being made by fully competent persons. But what about minors or mentally handicapped persons, who have never had full decisional capacity or patients who have lost decisional capacity before having the change of a high quality ACP process? Who supports surrogates in these situations? And how to enable the – sometimes only partly incompetent person to take part in ACP? We will discuss legal, ethical and practical issues and steps towards best practice of ACP for these groups of people.

Are there any presentations from the Inaugural Advance Care Planning Conference that you are particularly looking forward to?

 Actually there are indeed some of the real “hot topics” in research and implementation presented at the conference. On the conceptual level, the talk of Tuly Rosenfeld on ACP for vulnerable populations is –for me- one of the key topics that we really have to tackle. From the practical point of view, de-prescribing, addressed by Ian Manovel  is also an issue that is currently emerging as one of the most important issues in medicine. Less is sometimes more- not only with regard to economy but also in the field of health.

Do not miss the post-conference workshop; ACP for Patients Not Fully Capable or Incapable of Decision Making- Legal and Ethical Concepts and Practical Experiences. To be held on May 4th from 9am-12pm, featuring one of our keynote presenters, Dr Tanja Krones.

Her workshop will give delegates the opportunity to build a network for ACP strategies targeted to patients with deteriorated decisional capacity.

Tanja is one of 13+ expert speakers addressing all the latest talking points surrounding ACP. Join us in Sydney for more!

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