Advanced care directives
Key points
- Advanced care directives are specific instructions, prepared in advance, that are intended to direct a person's medical care if he or she becomes unable to do so in the future.
- Advanced care directives allow patients to make their own decisions regarding the care they would prefer to receive if they develop a terminal illness or contract a life-threatening injury.
- These are any decisions regarding care that are communicated verbally by an individual to his or her health care provider(s) and family members.
- SUMMARY The process of establishing advanced care directives may be difficult.
Alternative names
Special medical power of attorney; Power of attorney; Verbal directions for future care; Durable medical power of attorney; DNR - do not resuscitate; Organ donation; Living will
Definition
Advanced care directives are specific instructions, prepared in advance, that are intended to direct a person's medical care if he or she becomes unable to do so in the future.
Information
PURPOSE
Advanced care directives allow patients to make their own decisions regarding the care they would prefer to receive if they develop a terminal illness or contract a life-threatening injury. Advanced care directives are also used to designate someone the patient trusts to make decisions about medical care, if the patient becomes unable to make (or communicate) these decisions.
Federal law (1990 Patient Self-Determination Act) requires hospitals, nursing homes, and other institutions that receive Medicare or Medicaid funds to provide written information regarding advanced care directives to all patients and residents upon admission.
Potential advantages for individuals who develop advanced care directives include the following:
- Decreased personal worry
- Enhanced health care provider knowledge regarding patient's wishes
- Decreased application of "defensive medicine" by provider
- Decreased implementation of futile, costly, specialized interventions
- Decreased overall health care costs
- Decreased feelings of helplessness and guilt for family
- Decreased legal concerns for everyone involved
The primary limitation of advanced care directives is the inability to predict what situations may arise in the future or what new modes of care may be available for situations considered nearly hopeless today.
EXAMPLES OF ADVANCE DIRECTIVES
Verbal instructions. These are any decisions regarding care that are communicated verbally by an individual to his or her health care provider(s) and family members.
Organ donation. This may be accomplished by completing an organ donation card and carrying it in your wallet. A second card may be placed with important papers (such as a living will, insurance papers, and so on.) Most hospitals or other major health care centers have organ donor information available.
Many states offer people who are applying for new or renewed drivers' licenses the opportunity to make a decision regarding organ donation and have it recorded on the driver's license. More information may be obtained by calling 1-800-24-DONOR.
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.