Advance directives: implementation into clinical practice

Legislation recently passed by Congress will require health care organizations to maintain specific procedures regarding the right of patients to prepare advance directives. Previous studies have shown that patients may wish to discuss issues regarding future terminal care, but few patients complete living wills or durable powers of attorney. Although physicians often have positive attitudes regarding advance directives, the majority do not initiate discussions regarding these issues. The new regulations may increase the awareness of directives and increase the documentation of patients' desires into the medical record. However, the widespread acceptance of the advance directive and its impact on health care decisions remain to be seen.