“…Indeed, a successful ongoing communicative process (i.e., predicated on really listening to the patient) has long been touted as being essential to the goal of effecting a cluster of benefits for the population of persons with severe mental illness. As with the eol-AD, the processes relevant to PAD preparation, completion, and implementation have to deal with considerable uncertainty that involves shifting health conditions, changing emotional states, and disparate and uncoordinated health care service systems (Backlar, 2002).…”