Use of advance directives: a social work perspective on the myth versus the reality

The Directive to Physician (previously called Living Will) and Durable Power of Attorney for Healthcare Decisions documents are usually signed in the belief that one's wishes will be carried out in the future. Often, however, physicians and families discover that the documents are vaguely worded or leave the patient's intent and legal standing unanswered. Two additional documents that may aid the decision-making process are the Durable Power of Attorney for Healthcare Decisions and the Medical Ethics Decision Form. As important as such documents may become in the future, perhaps even more important will be the process individuals will go through defining what quality of life means to them by specifying their values and beliefs to their families and physicians before they face a crisis situation. Each individual has the right to choose or refuse medical treatment--the current struggle is for each individual to articulate his or her wishes based on a personal definition of quality of life set forth in a clear and legal framework.