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National Center for Ethics in Health Care

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The VA Life-Sustaining Treatment Decisions Initiative

The Life-Sustaining Treatment Decisions Initiative (LSTDI) is a national VHA quality improvement project that promotes personalized, proactive, patient-driven care for Veterans with serious illness by eliciting, documenting, and honoring their values, goals, and preferences.

Links and Files

Goals of Care Conversations
Resources for Veterans, Families, and Health Care Surrogates

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If you have a serious illness, set up a time to have a goals of care conversation with your VA health care team to discuss what matters most to you.

The Setting Health Care Goals handout explains the nature and purpose of goals of care conversations, helping prepare patients, families and health care surrogates for a discussion about the patient’s goals and life-sustaining treatment decisions. YouTube and podcast versions are also available.

Dialed In Podcast Series

Setting Health Care Goals When You Have A Serious Illness (5:56)

Would CPR Be Right for Me? (4:51)

Mechanical Ventilation — An Option for Breathing Problems (6:05)

Choosing A Health Care Agent (5:36)

Other resources for all Veterans on advance care planning and planning for future health care.


National Policy

VHA Handbook 1004.03, Life-Sustaining Treatment Decisions: Eliciting, Documenting, and Honoring Patients’ Values, Goals, and Preferences


LSTDI Overview and
VA Implementation

LSTDI Overview Video

LSTDI Overview PowerPoint

LST and Advance Directives Podcast

Video: Conducting a Goals of Care Conversation with a Patient


Goals of Care Conversations
Skills Training

Skills Training Materials for Non-VA Healthcare Professionals