• R P Hamel.
• Health Prog. 1988 Apr 1; 69 (3): 36-40, 88.

AbstractDecisions regarding life-sustaining treatment for incompetent patients are typically difficult and stressful for surrogate or proxy decision makers. Although substituted judgment and best interest provisions are helpful to next of kin or guardian and help replicate an incapacitated patient's wishes, a more definitive expression of treatment preferences is needed. Advance directives allow currently competent persons to express their wishes about medical treatment before a possible incapacitating situation. Such directives seek to realize basic values of human dignity, respect for self-determination and human life, and communication and discussion with the person concerning treatment. Three types of directives are the living will or instruction directive, proxy directive or durable power of attorney, and a combination of the two. Legislative concerns over advance directives mainly focus on possible legal euthanasia, patient protection, ambiguous language, and other inadequacies. Catholic healthcare facilities can respond to concerns about advance directives in four positive ways: Make information about directives available to patients and providers. Contribute to constructive debate in states without legislation. Include provisions for proxy decision making in states with existing patients' bill of rights. Consider legislation to protect physicians from litigation when patients' written directives are followed.

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