Advance Care Planning – What does it all mean?

With Dr. Ferdinando Mirarchi and Dr. Marie-Carmelle Elie

Christina Shenvi

This month we are looking at advance directives, DNR orders, living wills, MOST, and POLST forms. If you don’t understand what all of those are, then you should definitely listen! I am joined by Drs. Ferdinando Mirarchi and Marie-Carmelle Eliewho are researchers and leaders in the realm of palliative care and advance care planning.

Unfortunately, advance care planning is complicated by regional differences, policies, and differing scopes of definitions for orders. Listen for more information and ideas.

This episode is timed to coincide near April 16th which is National Healthcare Decisions Day! This exists (per their website here)  “to inspire, educate, and empower the public and providers about the importance of advance care planning.”


  1. Determine Whether Patient Video Testimonials Can Safely Help Ensure Appropriate Critical Versus End-of-Life Care. J Patient Saf. 2017;13(2):51-61.
  2. Mirarchi FL, Yealy DM. Lessons Learned From the TRIAD Research Opportunities to Improve Patient Safety in Emergency Care Near End of Life. J Patient Saf. April 2018:1.
  3. Guidelines for Emergency Physicians on the Interpretation of Physician Orders for Life-Sustaining Therapy (POLST). Ann Emerg Med. 2017;70(1):122-125.
  4. Richardson DK, Fromme E, Zive D, Fu R, Newgard CD. Concordance of out-of-hospital and emergency department cardiac arrest resuscitation with documented end-of-life choices in Oregon. Ann Emerg Med. 2014;63(4):375-383.

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Christina Shenvi


Dr. Christina Shenvi is an associate professor of Emergency Medicine at the University of North Carolina. She is fellowship-trained in Geriatric Emergency Medicine and is the founder of GEMCast. She is the director of the UNC Office of Academic Excellence, president of the Association of Professional Women in Medical Sciences, co-directs the ACEP/CORD Teaching Fellowship, is on the Annals of EM editorial board, is on the Geriatric ED Accreditation board of governors, and she teaches and writes about time management at

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