Advance Directives for Health Care

Presumably, most patients who express their wishes regarding future medical treatment by executing advance directives do so because they want and expect those wishes to be respected and followed. There is a substantial body of data, though, indicating that very often the stated wishes of patients regarding life-sustaining medical treatment are not respected and implemented. In actuality, critically ill patients frequently receive more aggressive medical treatment than they previously had said they would want.

State advance directive statutes all excuse a health care provider who chooses, for reasons of personal conscience, not to implement a patient's (or proxy's) expressly stated preferences regarding life-sustaining medical treatment, as long as that provider does not interfere with the patient being transferred to a different provider if that is what the patient or proxy wish. In the same vein, courts have refused to hold health care providers legally liable for failing to follow a patient's or proxy's instructions to withdraw or withhold particular forms of treatment, on the grounds that providing life-prolonging intervention can never cause the kind of injury or harm for which the legal system is designed to provide financial compensation.