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I think we unbelievably are! Note: That term is not in this
document that I found.

The actual VA document = July 2, 2009:

http://www.ethics.va.gov/docs/policy/VHA_Handbook_1004-02_Advance_Care_Planning_20090702.pdf

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Stunning .. how bureaucratized and roboticized the VA docs will have to be, in just one excerpt below .. they’re going to spend a lot of time being govt. functionaries. It would now be hard to believe that his evil plans, if successful, couldn’t extend to the broader population.

I agree it’s important to discuss these things with your family and personal doctor at appropriate age and time, but it’s possible to now visualize that every conversation with your physician will be quite regulated and get reported and put into their massive population/cost monitoring databank. 1984.

Obamacare MUST fail.
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Excerpt:

9. RESPONSIBILITIES OF THE PRIMARY CARE PRACTITIONER

Primary care practitioners are responsible for:

a. Raising the issue of advance care planning with all patients who have decision-making capacity, explaining that they do this with all their patients. These conversations may be brief, or more extensive, depending on the patient’s circumstances.

For patients who request more information and/or assistance completing advance directive forms, the primary care practitioner may personally provide the information and/or assistance, or make a referral to another qualified
individual (see paragraph 9).

b. Giving patients pertinent educational materials (e.g., Refer patients to the “Your Life, Your Choices” module in MyHealtheVet at the web site http://www.myhealth.va.gov, or provide written material such as Appendix C).

**The links that come up when you click that site above and search for ‘your life your choices.’**

http://www.index.va.gov/search/va/va_search.jsp?SQ=&TT=1&QT=your+life+your+choices&searchbtn=Search

c. Encouraging patients to discuss their preferences for future health care with their loved ones.

d. Explaining the potential benefits of advance care planning in general, and of advance directives in particular, especially for patients who are at high risk of losing decision-making capacity (e.g., patients with cerebrovascular disease, early dementia, or other serious mental or life-limiting illnesses).

e. Highlighting the particular benefits of appointing an HCA, especially if a problem related to surrogacy is anticipated (e.g., patients who have no family, patients who would want a surrogate other than the person authorized in VHA Handbook 1004.1, or patients with multiple
surrogates at the same priority level who may disagree with each other).

f. Describing the limitations of advance directives.

NOTE: Pertinent information is contained in the references cited in paragraph 8b, and in paragraph 14.

g. For patients who already have an advance directive in the health record, reviewing the advance directive with the patient to help ensure it is up to date, and that it states the patient’s intentions clearly (see paragraph 10c).

h. If the patient has more than one advance directive in the record, asking the patient to indicate which one(s) remains active and which, if any, needs to be rescinded because of changes in the patient’s preferences (see paragraph 11).

i. Initiating conversations about advance care planning periodically (at intervals no longer than three years), whenever the primary care practitioner observes a significant change in the patient’s health status, and at the earliest opportunity after a new or revised advance directive is entered into the patient’s record.

In addition, primary care practitioners need to initiate these July 2, 2009 VHA HANDBOOK 1004.029 conversations more frequently with patients who are at high risk of losing decision-making capacity (e.g., patients with cerebrovascular disease, early dementia, serious mental illness (SMI) or other life-limiting illnesses).

j. Documenting that the required advance care planning discussion occurred and summarizing the significant content.

(1) When the discussion results in the patient completing an advance directive, the advance directive must be filed or scanned with a progress note titled “Advance Directive.”

(2) Documentation of the discussion that led to the filing of an advance directive can be in the form of an addendum to the “Advance Directive” note associated with that advance directive or in a separate note titled “Advance Directive Discussion.”

(3) When there is discussion, but no advance directive, the note needs to have the title “Advance Directive Discussion.”

(4) When the discussion concerns an existing advance directive, documentation can be in the form of an addendum to the “Advance Directive” note associated with that directive or may be made in a separate note titled “Advance Directive Discussion” (see par. 5).

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“Your Life, Your Choices:
Planning for Future Medical Decisions

Note –

The following is a 1997 publication that was produced
under VA IIR Grant No. 94-050, “Development of an
Advance Care Planning Workbook,” 4/01/95 – 3/31/97.
The document is currently undergoing revision for
release in VA. The revised version will be available
soon.

http://www.ethics.va.gov/YLYC/YLYC_First_edition_20001001.pdf