[COPD. A model for using advanced directives and care planning].

Decision-making in COPD is complicated by the lack of clear prognostic factors. In this clinical situation it is also necessary to include the desires, values and choices of patients. The problem is more complex in the critical episodes, where the patients are incapable to make decisions. The instruments that allow incapable patients to represent themselves, the kind of patients who could benefit from its use, and the Spanish legislation on the matter, are presented in the first part of the work. The paper goes on to explain how to apply advance directives to the case of COPD. The article concludes that the appropriate use of advance directives and advanced care planning increases the quality of decisions at the end of the life of the patients with COPD."
(2009 SEPAR. Published by Elsevier Espana. All rights reserved.)