The Importance of Advanced Directives:
A New Year’s Resolution for Physicians and Patients
As physicians, one of your most critical roles is to empower our patients to make informed decisions about their health. An area often overlooked, yet profoundly impactful, is encouraging patients to complete an advanced directive. With the new year upon us, this is an ideal time to initiate these essential conversations with your patients.
What Are Advanced Directives?
Advanced directives are legal documents that allow individuals to outline their preferences for medical care in the event they cannot communicate their wishes. These documents include a living will and the designation of a healthcare power of attorney (POA). A living will specifies the types of life-sustaining treatments a patient may or may not want, such as mechanical ventilation or artificial nutrition. The healthcare POA identifies a trusted individual to make medical decisions on the patient’s behalf.
Why Are Advanced Directives Important?
Advanced directives provide clarity and guidance for healthcare teams and families during emotionally charged situations. By outlining preferences in advance, patients reduce the likelihood of family disputes, ensure their values and wishes are respected, and alleviate the emotional burden on loved ones forced to make difficult decisions.
From a clinical perspective, advanced directives facilitate better care coordination and decision-making. They provide a clear framework for implementing patient-centered care, particularly in critical care settings or at the end of life.
The Physician’s Role
Physicians are uniquely positioned to guide patients in understanding and completing advanced directives. Here’s how we can take a proactive approach:
- Start the Conversation Early: Discuss advanced directives during annual wellness visits or routine check-ups. Framing it as part of overall health planning helps normalize the discussion.
- Educate Patients on the Process: Patients may feel overwhelmed by the prospect of completing legal documents. Provide resources, such as templates or links to reliable sources like the Allegheny County Bar Association’s guide to living wills (available at https://www.acba.org/?pg=living-will).
- Address Misconceptions: Many patients believe advanced directives are only for the elderly or terminally ill. Reinforce that these documents are essential for all adults, as unforeseen events can happen at any age.
- Collaborate with Families: Encourage patients to discuss their wishes with family members and the individuals they plan to designate as healthcare POA. Open communication helps ensure everyone involved understands the patient’s choices.
- Incorporate Advanced Directives into Practice Workflows: Documenting discussions about advanced directives in the patient’s medical record and regularly reviewing them ensures that preferences remain up-to-date.
Encouraging Patients to Act in the New Year
The start of a new year is a natural time to set goals and prioritize important tasks. Encourage your patients to include completing an advanced directive as one of their resolutions. By presenting this as a proactive and compassionate step, you can help patients feel empowered rather than apprehensive.
Consider utilizing your practice’s communication channels, such as newsletters, patient portals, or social media, to share information about the importance of advanced directives. Providing easy access to resources and emphasizing the benefits can inspire patients to take action.
Several years ago, the Allegheny County Medical Society and the Allegheny County Bar Association collaborated to create an Advanced Directive document. This resource, available as a public service, supports patients in recording their wishes for end-of-life healthcare decisions.