Ep. 249 Improving Advance Directives by Using Video Technology with Fred Mirarchi MD

Learn how video tech is revolutionizing advance directives and about special training for death doulas to become ACP educators.

My guest Dr. Fred Mirarchi is an emergency medicine physician and the principal investigator of the TRIAD Research Series (The Realistic Interpretation of Advance Directives.) He’ll discuss how his research has confirmed that there is a nationwide patient safety risk due to confusion surrounding living wills, DNR and POLST orders. We will also talk about MIDEO, which is a video advance directive and physician’s medical order that improves both the quality and safety of advance care planning, AND his initiative to provide doulas with training to become ACP educators. Learn more at these websites:



Listen here:

Improving Advance Directives by Using Video Technology

This episode includes:

  • Significant problems with living wills and POLST orders revealed by TRIAD research
    • poorly understood by patients
    • misinterpreted by healthcare workers
    • forms not properly completed
  • Poor communication and lack of education create problems with advance care planning
  • “Effective” living will document differs from “Active” living will, which is triggered by a terminal event
  • Why video is more effective than a paper form for documenting patient wishes
  • How MIDEO works for creating video directives
  • Training physicians, doulas and other healthcare providers to help patients create video directives
  • How COVID-19 is currently affecting advance care planning
  • Moral injury is occurring for healthcare providers making difficult decisions during COVID-19

Links mentioned in this episode:

  • Get the book here: 7 Lessons for Living from the Dying
  • Doula training program on ACP and MIDEO
  • Learn about MIDEO here
  • Join the team at Patreon.com/eolu and get access to the EOLU mug“Mind if we talk about death?” (only Patrons can purchase it). PLUS get our new bonuses: the monthly EOL News Update, movie reviews from 2 Doctors and a Movie, and automatic access to A Year of Reading Dangerously!

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