Words to Describe What I’m Feeling: Exploring the Potential of AI Agents for High Subjectivity Decisions in Advance Care Planning

Loss of decisional capacity, coupled with the increasing absence of reliable human proxies, raises urgent questions about how individuals’ values can be represented in Advance Care Planning (ACP). To probe this fraught design space of high-risk, high-subjectivity decision support, we built an experience prototype (ACPAgent) and asked 15 participants in 4 workshops to train it to be their personal ACP proxy. We analysed their coping strategies and feature requests and mapped the results onto axes of agent autonomy and human control. Our findings show a surprising 86.7% agreement with ACPAgent, arguing for a potential new role of AI in ACP where agents act as personal advocates for individuals, building mutual intelligibility over time. We propose that the key areas of future risk that must be addressed are the moderation of users’ expectations and designing accountability and oversight over agent deployment and cutoffs.