Advance Directive Basics
A legal document that communicates a person's healthcare wishes in case they become unable to communicate or make decisions.
What is an Advance Directive?
A document that can describe a person's wishes regarding certain medical treatments, particularly in serious or end-of-life situations.
What is a living will?
Whose healthcare wishes should be at the center of advance-care planning?
Who is the patient?
Maria is unconscious after an accident. Her medical record contains an advance directive. Should the healthcare team ignore it because she cannot currently discuss it?
No. The healthcare team should follow applicable laws, policies, and procedures concerning the directive.
An advance directive can help communicate a person's healthcare wishes before they become unable to communicate.
True
One reason a person might complete an advance directive while they are healthy.
What is to communicate their healthcare wishes in advance?
A person designated to make healthcare decisions for a patient who is unable to make them.
What is a healthcare agent/proxy?
A healthcare worker should never replace a patient's wishes with this.
What is the healthcare worker's personal opinion?
A patient's family members disagree about what the patient would want. The patient has documented healthcare wishes. What information should the healthcare team consider?
The patient's documented wishes/advance directive, along with applicable law and healthcare procedures.
A DNR and an advance directive are exactly the same thing.
False
Advance directives are especially useful when a patient is unable to do what?
What is communicate or make healthcare decisions?
This ethical principle refers to respecting a patient's right to make decisions about their own healthcare.
What is patient autonomy?
A healthcare worker discovers information about a patient's advance directive. What important patient right must also be protected?
What is privacy/confidentiality?
A healthcare worker says, "I don't personally agree with this patient's healthcare wishes, so I'll ignore the advance directive." What is wrong with this response?
The worker is substituting their personal beliefs for the patient's documented wishes and their professional responsibilities.
A healthcare agent may be designated to make healthcare decisions for someone who cannot make them.
True
Advance directives can help healthcare providers and families understand whose wishes should guide healthcare decisions.
What is the patient's wishes/preferences?
A medical order that specifically addresses whether CPR should be performed if a patient's heart or breathing stops.
What is a DNR order?
If a healthcare worker is unsure how an advance directive applies to a patient, they should follow facility procedures and communicate with whom?
Who is the appropriate healthcare team/supervisor?
A patient has designated their daughter as their healthcare agent. The patient later becomes unable to make healthcare decisions. What is the daughter's role?
She may serve as the patient's authorized healthcare decision-maker, subject to the document and applicable law.
Healthcare workers should give patients legal advice about how to create or change an advance directive.
False. Healthcare workers should work within their scope and refer patients to appropriate resources/professionals when legal assistance is needed.
True or False: An advance directive means a patient is refusing all medical treatment.
FALSE. An advance directive can communicate preferences about different types of healthcare and may designate a decision-maker.
This term describes a patient's voluntary agreement to treatment after receiving appropriate information about the treatment.
What is informed consent?
Why is respecting advance directives connected to patient autonomy?
Because advance directives allow patients to communicate their own healthcare preferences and choices, including plans for situations in which they may no longer be able to speak for themselves.
A student says, "The family always gets to decide what happens to an unconscious patient." Is this always true?
No. Decision-making authority depends on the patient's wishes, applicable law, and the circumstances. An advance directive may designate a healthcare agent or provide treatment instructions.
Advance directives are only important for elderly patients.
False. Adults of different ages may choose to plan ahead for unexpected illness or injury.