Challenges in advance care planning: the interface between explicit instructional directives and palliative care

Peter Eastman, Danielle Ko and Brian H Le
Med J Aust 2020; 213 (2): . || doi: 10.5694/mja2.50653
Published online: 15 June 2020

This case study highlights some important legal and ethical considerations related to advance care planning

A 71‐year‐old man with vascular risk factors including hypertension and hypercholesterolaemia lived at home with his wife and enjoyed reading, listening to music and discussing global issues. Immediately on disembarkation from a long flight, he experienced a sudden reduction in consciousness with accompanying right hemiplegia and neglect. He was diagnosed with a large left middle cerebral artery infarct and underwent thrombolysis. Following the procedure, he was haemodynamically unstable, with further investigation revealing massive pulmonary emboli. He was anticoagulated and his condition stabilised.

  • Peter Eastman1,2
  • Danielle Ko3
  • Brian H Le1,4

  • 1 Parkville Integrated Palliative Care Service, Royal Melbourne Hospital, Melbourne, VIC
  • 2 University Hospital Geelong, Geelong, VIC
  • 3 Austin Health, Melbourne
  • 4 Parkville Integrated Palliative Care Service, Peter MacCallum Cancer Centre, Melbourne, VIC


Competing interests:

No relevant disclosures.


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