If you have been diagnosed with a terminal illness or have concerns about your future healthcare, advance care planning can help make sure your wishes are known and respected. Advance directives are a critical part of this process, allowing you to document your preferences for medical care treatment if you become unable to communicate them yourself.
While they may be effective at communicating your wishes, advance directives are also subject to several limitations. These limitations may affect the effectiveness of these directives and even prevent your wishes from becoming known. They include the following.
Inaccessibility
In some cases, the advance directive documents may not be accessible to the relevant healthcare providers when critical decisions need to be made. This can occur if the documents are not properly shared, stored or included in your medical records. For example, if you fail to provide copies to your primary physician, hospital or trusted family members, medical teams may be unaware of your expressed wishes during emergencies. Healthcare providers may also not have the time or ability to locate these documents, particularly in situations requiring urgent action, which could result in decisions being made contrary to your preferences.
Lack of relevance or enforcement
Sometimes, even when advance directives are accessible, they may not fully relate to the specific medical situation or your current wishes. Directives created years earlier might be outdated, or the language used could be too vague to guide healthcare providers effectively. Enforcement may also become an issue if medical professionals prioritize emergency protocols or are unclear about their obligation to follow the document.
Inapplicability
Advance directives generally apply only in certain situations, such as when someone has a terminal illness or is permanently unconscious. Confirming these conditions can sometimes take a significant amount of time, leading to unwanted medical interventions or extended hospital stays that may cause additional suffering.
To make sure your advance directives are clear, relevant and enforceable, it is important to consider seeking legal guidance. This will help ensure the document accurately reflects your wishes and is properly shared with all necessary parties.