Legal Definitions - advance directive

An advance directive is a legal document that allows an individual to make decisions about their future medical care and treatment, or to appoint someone to make those decisions on their behalf, in the event they become unable to communicate their wishes due to illness or incapacity.

These directives are created while a person is mentally competent and typically come into effect only when a medical professional determines the person can no longer make or express their own healthcare choices. They ensure that an individual's preferences regarding medical treatment, such as life support, pain management, or specific interventions, are respected, or that a trusted person is empowered to make choices consistent with their values.

• Example 1: Appointing a Healthcare Agent

  Sarah, a 35-year-old software engineer, creates an advance directive that designates her sister, Jessica, as her healthcare agent. This document specifies that if Sarah were ever in a coma or otherwise unable to make medical decisions for herself, Jessica would have the legal authority to speak with doctors and make choices regarding Sarah's treatment, guided by Sarah's known values and preferences.

  This example illustrates an advance directive's role in appointing a surrogate decision-maker, ensuring that a trusted individual can advocate for the patient's best interests when they cannot.

• Example 2: Stating Specific Treatment Preferences (Living Will)

  Mr. Chen, an 80-year-old with a chronic lung condition, signs an advance directive known as a "living will." In this document, he explicitly states that if he were to suffer from a terminal illness with no reasonable hope of recovery, he would not want to be kept alive indefinitely by artificial means, such as mechanical ventilation or feeding tubes. He prefers comfort care focused on pain relief.

  This example demonstrates how an advance directive can directly communicate an individual's wishes regarding specific medical treatments, ensuring their preferences for end-of-life care are honored.

• Example 3: Comprehensive Planning for Progressive Illness

  Maria, recently diagnosed with early-stage Parkinson's disease, completes an advance directive that includes both the appointment of her adult son, David, as her healthcare proxy and detailed instructions about her future care. She outlines her preferences for where she would like to receive care (e.g., at home versus a facility), her stance on aggressive treatments versus palliative care as her condition progresses, and her desire for specific spiritual support. This document will guide David and her medical team as her illness advances.

  This example shows how an advance directive can be a comprehensive tool, combining the designation of a decision-maker with specific instructions for a range of future medical and personal care scenarios, particularly relevant for progressive conditions.