The Ethical Implications of Ineffective Advanced Directive Use

A patient, their family members, and their healthcare team all play a role in collectively deciding if and when it is best to withhold or withdraw life-sustaining therapies for a patient in an end-of-life situation. Although in some instances these difficult conversations are able to be held in advance, in many other cases end-of-life care decisions are required to be made in high-pressure situations with less time available due to unforeseen circumstances. Through the practice of narrative medicine, these conversations are especially important when trying to preserve or “hold” a patient\u27s identity for the time that they are alive rather than just delaying death. While advanced directives can play an important role in ensuring more ethical and comfortable end-of-life care, in our current status quo, the ineffective implementation of these legal/medical documents creates ethical concerns that go against the fundamental prioritization of a patient’s wishes and comfort. We will further explore how many people fill out advance directive forms, which demographics tend to rely on them, and the issues that often arise during the implementation of these forms