Very good article. I think there is an important distinction between acute and chronic disease, with respect to how much time you have to consider the choices you need to make - while you retain the capacity to make them.
In the UK there is an initiative to address some of these problems by having a proactive conversation with all patients before they become too sick. The ReSPECT process (https://www.resus.org.uk/respect/respect-healthcare-professi...) encourages clinicians and patients to establish a shared understanding of what outcomes the patient values and fears before recommending which clinical treatments they would and would not benefit from. It's adoption here has been very positive - for context there have been multiple problematic issues with the use of DNAR (Do Not Attempt Resuscitation) form - especially during the pandemic.
In the UK there is an initiative to address some of these problems by having a proactive conversation with all patients before they become too sick. The ReSPECT process (https://www.resus.org.uk/respect/respect-healthcare-professi...) encourages clinicians and patients to establish a shared understanding of what outcomes the patient values and fears before recommending which clinical treatments they would and would not benefit from. It's adoption here has been very positive - for context there have been multiple problematic issues with the use of DNAR (Do Not Attempt Resuscitation) form - especially during the pandemic.