Advance decisions to refuse treatment component of the Mental Capacity Act

In January 2007 a project team was commissioned by the Department of Health to develop specialist guidance for advance decisions to refuse treatment (ADRT). ADRT is one component of the Mental Capacity Act (MCA) 2005, which provides a statutory mechanism protecting the advance decision-making process for people, particularly those who have a long-term condition and those approaching end-of-life care. The ADRT project team is hosted by the Mid-Trent Cancer Network and works in close association with Care Services Improvement Partnership East Midland. ADRT is an integral part of advance care planning and its creation can protect patient choice before capacity is lost, often allowing death with privacy and dignity. Since October 2007 professionals and organizations have a legal duty to support ADRT and the MCA implementation. The aim of this article is to provide a practical introduction to ADRTs, focusing on the content of the ADRT specialist guidance and how this can be used to support implementation, education and training related to ADRT. Advance care planning is a significant component of the recently published End-of-Life Care Strategy.     

Using plain language skills to create an educational brochure about sperm banking for adolescent and young adult males with cancer

Writing in plain language makes it easier for patients to read, understand, and make informed decisions about sperm banking. Greater attention to the issue and properly designed educational brochures for use by nurses in oncology and reproductive health is of evident importance but of unknown impact. A multidisciplinary clinical team followed an evidence-based, patient-centered approach to develop "plain language" patient education materials about sperm banking for adolescent and young adult (AYA) males with cancer. A patient education booklet was produced and implemented as part of the planned patient education for AYA male oncology patients at McMaster Children's Hospital, Hamilton Health Sciences, in Hamilton, Ontario, Canada. The patient education booklet for use by health professionals as a teaching tool to facilitate discussion with AYA males has been produced with the hope that it will contribute to better informed decision making regarding sperm banking and increased use of this technology for fertility preservation.