Editorial

Advance Directives to Physicians: What Every Physician Should Know

Authors: Craig M. Klugman, PhD

Abstract

Advance care planning is the process of working with patients to consider, converse about, and write about their future healthcare plans in the event that they are no longer able to make their own decisions. A large component of this process is completing the advance directive. Advance directives are composed of an instruction to the physician that outlines a patient’s desired and undesired medical care treatment and appoints a healthcare surrogate who makes decisions and speaks as the patient’s voice. Some patients also may choose to have an out-of-hospital do-not-resuscitate (DNR) order, which allows prehospital health professionals to cease (or not begin) resuscitation on a patient in cardiopulmonary failure. The policies of some long-term care institutions may state, however, that such out-of-hospital DNR documents will not be honored. Several states have put in place Physician Orders for Life-Sustaining Treatment (POLST), a physician’s order that follows the patient (not the institution) and thus is valid in both in-hospital and out-of-hospital settings. Patients also need to carefully distribute and store their advance care planning documents so that they are available when needed.

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