Legal Definitions - instruction directive

An instruction directive is a formal written document in which an individual clearly outlines their specific preferences and decisions regarding their future medical care and treatment. It serves as a direct guide for healthcare providers and family members, ensuring that the individual's wishes are honored if they become unable to communicate them directly.

• Example 1: End-of-Life Treatment Choices

  A healthy 55-year-old individual, concerned about potential future incapacitation, drafts an instruction directive. In this document, they explicitly state that if they were to enter a persistent vegetative state with no reasonable hope of recovery, they would not want to be kept alive indefinitely by artificial means, such as mechanical ventilation or feeding tubes. They specify that comfort care should be prioritized in such a scenario.

  This illustrates an instruction directive because it is a written statement detailing specific healthcare decisions (refusal of certain life-sustaining treatments) made by the individual for a future situation where they cannot speak for themselves.

• Example 2: Religious or Personal Beliefs Regarding Medical Procedures

  A person whose religious beliefs prohibit blood transfusions prepares an instruction directive. This document clearly states their refusal of blood transfusions under any circumstances, even if their life is at risk, and requests that alternative medical treatments be explored. They also specify that this refusal applies even in emergency situations where they might be unconscious.

  This demonstrates an instruction directive as it provides specific, non-negotiable directions concerning a particular healthcare decision (refusal of blood transfusions) based on the individual's deeply held personal beliefs.

• Example 3: Preferences for Specific Medical Interventions After a Major Accident

  Following a serious car accident, a 30-year-old is in a coma. Prior to the accident, they had created an instruction directive outlining their preferences. In it, they had specified that if they were to suffer a severe brain injury resulting in permanent cognitive impairment, they would prefer not to undergo extensive, invasive surgeries or long-term rehabilitation if the prognosis for a meaningful recovery was extremely low. Instead, they requested palliative care focused on comfort.

  This example highlights an instruction directive because it contains precise directions about the type and extent of medical interventions (or lack thereof) the individual desires in a specific health crisis, guiding medical staff when the patient cannot express their wishes.