The major argument for the use of instructive directives, such as a living will,
is that it allows an individual to participate indirectly in future medical care
decisions even if they become decisionally incapacitated, i.e., unable to make informed
decisions. Instructive directives may extend individual autonomy and help ensure
that future care is consistent with previous desires. The living will was created
to help prevent unwanted and ultimately futile invasive medical care at the end-of-life.
When patients becomes incapacitated someone else will be required to make medical
decisions regarding their care. Generally a spouse is the legal surrogate. If no
spouse is available, the state law designates the order of surrogate decision makers,
usually other family members. By designating a DPAHC, the patient's choice of a
surrogate decision maker supersedes that of the state. A legal surrogate is particularly
valuable for persons in non-traditional relationships or without close family. The
DPAHC need not be a relative of the patient, though this person should have close
knowledge of the patient's wishes and views.
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