Aims: Photographs, writing, voice recordings and social-media accounts outlive their creators, and generative artificial intelligence (AI) can recreate them after death. Patients and families raise these questions in clinic, but advance care planning (ACP) services have no structured way to ask or record the answers. We developed a questionnaire-style aid for handling digital legacy after death within ACP consultations.
Methods: We conducted evidence-informed prototype development. PubMed was searched using nine queries covering digital legacy, posthumous data or AI, ACP, cancer and palliative care, and conversation-aid development. Titles and abstracts were screened and concepts extracted from retained records, supplemented by oncology ACP guidelines, digital-afterlife ethics papers and post-death account policies. Concepts were grouped into domains and translated into plain-language questions, response options and documentation fields, ordered from permission and conventional data management to AI-assisted and AI-generated uses, with opt-out and safety rules.
Results: The aid covers ten domains. Patients state their readiness and values, then which photographs, messages, cloud data and accounts to preserve, delete or keep private, and from whom; who can manage their accounts after death; what should reach family; and whether AI may organize that material. A high-risk section asks whether an AI may write replies in their style, speak in their voice or appear as an avatar, and if so for what purpose, how long, how it must be labelled, and who should stop it. Twenty-seven prompts carry explicit permit, refuse or defer options; the rest are free text. Twenty rest on team judgment. An unrecorded preference counts as refusal: a blank is never permission.
Conclusions: To our knowledge this is the first structured aid making digital legacy after death explicit ACP content. It is a prototype; validation through patient and legal-expert views is planned.