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Previous Volume 336:662-663 February 27, 1997 Number 9 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: In his article on the trend toward using "advance care planning" as a guise for limiting treatment (Sept. 5 issue),¹ Levinsky sounds many appropriate warnings. Advance planning is intended to ascertain and clarify "patient preferences," and if the guidelines are followed, we assume that a patient's preferences have been heeded.

But can we accurately or adequately know what these "preferences" are — or study them — when patients' and families' choices are severely constrained in the existing health care system? Some patients (and their physicians) may not know about the many alternatives that exist between the extremes . . . [Full Text of this Article]

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