Mapping advance care planning and advance directives in Latin America

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dc.article.number226
dc.catalogadorpva
dc.contributor.authorTardelli, Natália R.
dc.contributor.authorFukushima, Fernanda B.
dc.contributor.authorVan der Steen, Jenny T.
dc.contributor.authorRodríguez, Manuel I. C.
dc.contributor.authorMikelyte, Rasa
dc.contributor.authorForte, Daniel N.
dc.contributor.authorPalácio, Alex S. W.
dc.contributor.authorTripodoro, Vilma A.
dc.contributor.authorBurgoa, Mirna G.
dc.contributor.authorCrispim, Douglas H.
dc.contributor.authorRodríguez Núñez, Alfredo
dc.contributor.authorCruz, Luis R. G.
dc.contributor.authorSáez, Mariuska F.
dc.contributor.authorBonilla Sierra, Patricia
dc.contributor.authorEscobar, Ancu T. F.
dc.contributor.authorAlcántara Godoy, María E. del Rosario
dc.contributor.authorCastellanos, Tulio E. V.
dc.contributor.authorSaldaña, Mónica O.
dc.contributor.authorReyes, Nisla C.
dc.contributor.authorRíos, Miriam E. R.
dc.contributor.authorBerenguel Cook, Maria del Rosario
dc.contributor.authorPichardo, Gloria C.
dc.contributor.authorAguilar, Carlos F. A.
dc.contributor.authorAlvarez, Gabriela P.
dc.contributor.authorGonzalez, Ismariel I. E.
dc.contributor.authorRodrigues Brito, Leonardo de Andrade
dc.contributor.authorIglesias de Oliveira Vidal, Edison
dc.date.accessioned2025-09-29T15:01:29Z
dc.date.available2025-09-29T15:01:29Z
dc.date.issued2025
dc.date.updated2025-09-07T00:04:46Z
dc.description.abstractBackground/aims The extent to which low- and middle-income countries have implemented Advance Care Planning (ACP) and Advance Directives (AD) remains unclear. We aimed to map the current status of ACP/AD in Latin America. Methods This cross-sectional, mixed-methods survey of ACP/AD in LA comprised interviews with 18 key informants from 18 out of 20 countries, most of whom were appointed by national Palliative Care Associations. Online interviews were conducted with each informant, covering a range of relevant topics from AD regulations to the use of ACP/AD in the context of end-of-life clinical decision making. We performed member checking and data triangulation to confirm our findings. Results Only eight (44%) countries have some form of ACP/AD regulations. Most regulatory frameworks tend to adopt a legalistic pattern heavily influenced by the North American model. Despite that characteristic of AD regulations in LA, the leading strategy used by patients to avoid unwanted treatment at the end of life is through conversations with their families, whereas the least common strategy was consulting with a lawyer. In six (33%) countries, informants believed it was common for patients to grant their families permission to modify their previous choices regarding future treatments. The religiosity/spirituality of populations play an important role in the implementation of ACP in the region. Additionally, respecting patients’ preferences of care at the end of life appears to be tied more to aspects related to the characteristics of doctor-patient relationship, and the degree of integration of palliative care into the healthcare system than the existence or content of AD regulations. There was consensus that none of the countries provide sufficient education about ACP/AD to healthcare professionals. Conclusions Our findings encourage rethinking ACP/AD in LA from a decolonial perspective, considering characteristics such as the preference for a relational model of autonomy in several countries and the importance of taking the religiosity/spirituality of individuals into account during ACP conversations. Our data also suggest that honoring patients’ preferences of care at the end of life entails integrating palliative care into health care systems, educating healthcare professionals and the population, and fostering longitudinal trusting relationships between those professionals, patients, and their families.
dc.fechaingreso.objetodigital2025-09-07
dc.format.extent20 páginas
dc.fuente.origenBiomed Central
dc.identifier.citationBMC Palliative Care. 2025 Sep 06;24(1):226
dc.identifier.doi10.1186/s12904-025-01849-5
dc.identifier.issn1472-684X
dc.identifier.urihttps://doi.org/10.1186/s12904-025-01849-5
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/105803
dc.information.autorucEscuela de Medicina; Rodríguez Núñez, Alfredo; 0000-0002-3123-653X; 120368
dc.issue.numero1
dc.language.isoen
dc.nota.accesocontenido completo
dc.publisherSpringer Nature
dc.revistaBMC Palliative Care
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.rights.licenseAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectAdvance care planning
dc.subjectAdvance directives
dc.subjectPalliative care
dc.subjectAging
dc.subjectCross-sectional studies
dc.subjectLatin America
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleMapping advance care planning and advance directives in Latin America
dc.typeartículo
dc.volumen24
sipa.codpersvinculados120368
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