P-105 Autonomy and acp: The failure of respect for autonomy to result in autonomous decision-making

Abstract

Background Respect for autonomy (RfA) is often talked about and treated as the conceptual core of advance care planning (ACP). Yet the philosophical and ethical relationship between RfA and ACP has not been carefully explored in the literature on ACP. One on hand, tying ACP to RfA makes sense given that the goals of ACP are to identify and honour persons’ treatment preferences when they are no longer decisional. On the other hand, ACP models or tools that are based solely on RfA often fail in practice. Aim This presentation aims to address the value and limits of RfA as an essential component of ACP, and to discuss how accurately identifying and communicating care plans requires a pluralistic ACP model not based solely on RfA. Methods To achieve this aim in the allotted time, a comparison will be made between ACP models that do not first explore the persons’ understanding of their medical conditions and their values and preferences against ACP models that begin planning with such an exploration. Results N/A Discussion N/A Conclusion Two concluding points will be demonstrated: 1) that ACP models that take RfA as their sole conceptual core are actually autonomy-constraining, thereby partially explaining their general failure in practice, and 2) public policy support of ACP should be for pluralistic models rather than one based on any one conceptual component, such as RfA.