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Advanced Care Directives
Alternate Names : DNR - Do Not Resuscitate, Durable Medical Power of Attorney, Living Will, Organ Donation, Power of Attorney, Special Medical Power of Attorney, Verbal Directions for Future Care
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.
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Description
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.
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Review Date : 12/23/2002
Reviewed By : Steven Angelo, M.D., Assistant Professor of Medicine, Yale School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network.
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