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Advance Directives

The ethical basis for preparing an advance directive regarding health care is the moral and legal right of every adult to accept or refuse recommended medical treatments. Each individual can decide what medical care to accept and what to reject. Physicians, hospitals, and nursing homes must respect the wishes of competent adults, even if they disagree with certain decisions. Some people may decide that they do not want to accept a medical treatment or be on a type of life support system if they have a terminal or progressive illness and functional or cognitive disabilities, while others in similar situations may want to be sure that such treatments are continued.

If an injury or illness prevents a person from making a decision or communicating wishes, however, the situation may become far more complicated. Often the hardest decisions about life-sustaining or invasive treatment must be made by others, usually family members, who may not know whether their loved one would or would not want treatment. Therefore, it is advisable for adults of all ages to do some advance planning and use one or more advance directives to convey their wishes and decisions. The most common ways to provide guidance are to leave specific instructions, often called a living will, or to designate and authorize someone to make medical decisions in the event of incapacity.

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