Legal Definitions - directive to physicians

A directive to physicians is a legal document that allows an individual to make decisions about their future medical care, particularly regarding life-sustaining treatments, in advance. It ensures that their wishes are respected if they become unable to communicate those decisions themselves due to illness or injury. This document empowers individuals to either refuse certain medical interventions or to appoint someone else to make those decisions on their behalf. It is often referred to by other names such as a living will, health care directive, or advance directive. The specific rules for creating and validating a directive to physicians can vary significantly depending on state law.

• Example 1: Refusing Specific Treatments for a Progressive Illness

  Sarah, a 70-year-old woman, has been diagnosed with a progressive neurological condition. She understands that eventually, she might lose the ability to swallow and breathe independently. Sarah creates a directive to physicians stating that if she reaches a point where she can no longer breathe on her own, she does not wish to be placed on a ventilator or receive a feeding tube. She wants comfort care only.

  This illustrates a directive to physicians because Sarah is proactively making a decision to refuse specific life-sustaining treatments (ventilator, feeding tube) in a future, life-threatening health situation where she might be incapacitated.

• Example 2: Broad Refusal in Cases of Irreversible Incapacitation

  Mark, a healthy 45-year-old, wants to ensure his family isn't burdened with difficult decisions if he were to suffer a catastrophic accident that leaves him in a permanent coma with no hope of recovery. He executes a directive to physicians that broadly states his wish to decline all life-sustaining treatments, including artificial hydration and nutrition, if he is diagnosed by multiple physicians as being in a persistent vegetative state with no reasonable expectation of regaining consciousness.

  This example shows a directive to physicians being used to make a broad decision about refusing life-sustaining care under very severe, irreversible conditions, preventing medical interventions that would prolong life without meaningful recovery.

• Example 3: Appointing a Healthcare Decision-Maker

  Elena, a single mother, wants to ensure that her sister, Maria, has the legal authority to make medical decisions for her if Elena ever becomes unconscious and unable to communicate her wishes. Elena trusts Maria completely to understand her values and make choices consistent with them. Elena completes a directive to physicians that not only outlines some general preferences but also explicitly designates Maria as her healthcare agent or proxy, granting Maria the power to make all medical treatment decisions on Elena's behalf should Elena become incapacitated.

  This demonstrates a directive to physicians by showing how it can transfer the authority to make medical decisions to another individual (Maria) if the person creating the directive (Elena) becomes incapacitated, ensuring someone she trusts will advocate for her care.