Patient autonomy is a guiding principle in medical decision-making in America.
This is challenging when patients become mentally incapacitated and cannot express their preferences. ACP is a deliberative and communicative process that helps people formulate and communicate preferences for future medical care in the event of mental incapacity. ACP discussions between patients and health care providers and patient- orientated educational ACP materials often ignore insights from 2 related activities, health promotion and human information processing. More effective ACP should occur with greater attention to the concepts of stages of change and self-efficacy, the Health Belief Model, and the necessary requisites for cognitive integration.