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Advance directives were created in response to the increasing sophistication and prevalence of medical technology. [3] [4] Numerous studies have documented critical deficits in the medical care of the dying; it has been found to be unnecessarily prolonged, [5] painful, [6] expensive, [7] [8] and emotionally burdensome to both patients and their families.
Patient rights include: The right to facilitate their own health care decisions; The right to accept or refuse medical treatment; The right to make an advance health care directive; Facilities must inquire as to whether the patient already has an advance health care directive, and make note of this in their medical records.
An advance directive allows an individual to state what treatments he or she would want in a medical crisis, but it is not a medical order. [4] Advance directives are not portable in a sense that it is not accessible across medical systems, so it is the individual's responsibility to have the form on them at all times. [ 4 ]
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Where the patient's advance decision relates to a refusal of potentially life-saving or life prolonging treatment, this must be recorded in writing and witnessed. Any advance refusal is legally binding, providing that the patient is an adult, the patient was competent and properly informed when reaching the prior decision.
When filing an advance directive, an alternate health care agent should be identified. The surrogate decision maker must be a trusted individual that is able to make crucial decisions on behalf of the advance directive client. The advance directive should also indicate specific instructions for when a patient is incapacitated.
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