Advance directives do provide insight to what a person’s wishes are. I have experienced that families that override the advance directive of their loved one – especially those members who have “unfinished business.” Unfortunately doctors tend to follow the family’s wishes fearing a lawsuit if they do not. When I talk with family members, my approach is to as them what their loved one would want in this situation rather than the question that is typically asked: “What do you want us to do for your loved one?” The decision the team is looking for is ultimately the patient’s whether that comes from the patient or through their loved ones. When I help people complete an advance directive I encourage them that having the talk with their loved ones before in a crisis is important to let them know what they want. I believe this conversation is also important for the doctors to have with the people under their care.
Another question I raise with families is: Are we prolonging life or dying? These questions seem to help some people through the process.