Designing advance care (incapacity) planning and advance directives legislation in British Columbia
Bibliographic record
Abstract
Responding to societal demands, the Province of British Columbia legislators began amending its health care consent and personal planning statutes in 2005, with a particular view to strengthen Advance Care Planning and make Advance Directives a legal option. Initial frameworks met with concern by professional and public organisations and feedback was provided to the Attorney General's office as well as to the Ministry of Health. Province wide consultation with stakeholders informed the new laws which were passed in 2007 and came into force in September 2011. These comprised options for Advance Directives as well as appointment of Substitute Decision Makers (called Representatives). The nature and scope of this collaboration process will be described. Consultations with clinicians, local health care administrators and Advance Care Planning professionals led to a province-wide approach in developing the legislation and regulations, leading to the production of provincially standardised products. These tools include Health Care Provider and Patient and Family guidebooks for developing optional advance care plans, advance directives and representation agreements which do not require lawyer visits. Educational materials (e.g. FAQs, and PowerPoints) have also been developed to educate and upskill health care providers in ACP, and inform them of their responsibilities within the new legislation. This has included the physician community with the development of physician specific materials including a “primer” on the legislation and an ACP video. The process of development of the educational materials and the materials themselves will be shared with participants.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.010 | 0.005 |
| Scholarly communication | 0.006 | 0.002 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".