This website was designed in collaboration with Australian religious and cultural leaders and organisations. It is intended to provide informational support for health professionals conducting advance care planning with people from different religious and cultural backgrounds. The website is open access and may be utilised by members of the general public. Information available on this website has been provided as a guide only and should not be generalised to all people of a particular religion/faith or culture.
The 'search' function enables users to select a religion and denomination (if applicable) and review background information and advice on advance care planning conversations for that particular religion/faith.
ACPTalk has been funded by the Australian Government Department of Health and developed by Cabrini Health in consultation with healthcare professionals, religious and cultural leaders and organisations Australia wide. Content was derived from interviews and has been reviewed by representatives from religious and cultural organisations and other interested external stakeholders.
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About Advance Care Planning
What is Advance Care Planning?
Advance care planning is the process of discussing a person's preferences for future health while the person is still capable of making decisions based on their own beliefs and value. Advance care planning supports the principles of autonomy, respect and dignity as it enables people to exercise control over future health care decision-making.
Who can be involved?
Advance care planning may involve a range of healthcare professionals including general practitioners, nurses, social workers, spiritual care professionals and specialist palliative care consultants. Conversations may be challenging for health professionals, patients and families.
Despite this discomfort, conversations are intended to be of benefit to the person, family, health professionals and health care services and systems as conversations encourage people to consider how their values, preferences and beliefs influence future health decisions. These discussions are intended to provide person-centred care and clarity in relation to treatment choices. A recent Australian-based study has shown that advance care planning has improved end of life care and patient and family satisfaction. This study reported reductions in stress, anxiety and depression among relatives.
When can ACP discussions occur?
Early conversations are encouraged. Life events such as coming of age, marriages, writing wills, illness in partner or family members, divorce, bereavement or entry into retirement village may be prompts for advance care planning conversations. Conversations may also be triggered by the diagnosis of a new medical condition, a change in medical prognosis or a routine visit to the general practitioner. Discussion can sometimes occur when patients are admitted to a hospital or if a change in health status occurs while a person is hospitalised.
Some people begin advance care planning discussions in the comfort of their home with members of their family and trusted friends. Advance care planning can be revisited over time and as clinical and life circumstances change.
What does a plan look like?
In some cases, advance care planning conversations may be formalised in written documentation, advance care directives. Formalised documentation may include a statement of preferences for refusal of treatment as well as a nominated decision maker on the person's behalf (e.g. surrogate decision maker or medical power of attorney). Formalised advance care plans can also be added to one's central electronic My Health Record so healthcare professionals may access it at any time if required.
What about religion and culture?
Religion and culture have been shown to influence advance care planning. Advance care planning principles value patient autonomy, informed decision making, truth telling and the individual's control over the dying process which may conflict with the beliefs and values of some people from different religions and cultures .
An understanding of different religious and cultural beliefs and values when initiating an ACP conversation can assist health professionals. However, within any particular religion or culture, there may be a range of expressions and levels of religiosity. It is important for health professionals to be aware of a patient's background and beliefs.
- Victorian Department of Health, Advance care planning: have the conversation. A strategy for Victorian health services 2014–2018. 2014.
- Detering, K.M., et al., The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. British Medical Journal, 2010. 340(c1345).
- Australian Government Department of Health. My Health Record. 2016 [cited 2016; Available from: https://myhealthrecord.gov.au/internet/mhr/publishing.nsf/content/home
- Johnstone, M. and O. Kanitsaki, Ethics and advance care planning in a culturally diverse society. Journal of Transcultural Nursing, 2009. 20(4): p. 405-416 12p.