Advance Directives

Marie Garavaglia

ENG W-233

Final Draft - Revised

4-27-2012

Advance Directives

Everyone needs to have an Advance Directive in place. An Advance Directive is a document that expresses a person’s wishes for critical care, in the event that that person cannot make a decision for his or herself. There are many types of Advance Directives. They all work in unison and describe different levels of care. These Advance Directives are so important that the court system has become involved in some cases and laws have been passed regarding them. It is so important that the majority of nursing homes require them upon admission to their facility. Because of this, communication with family members and physicians is imperative. Many physicians and family members are unaware of a patient’s wishes and desires regarding end of life decisions, until it’s too late to ask them. This may lead to unnecessary treatments, pain, prolonging of life or suffering on the part of the patient and the family.

There are two well know cases that exemplify Advance Directives perfectly. The first case involves a twenty one year old woman named, Karen Quinlan. Karen was drinking with some friends, and feeling tired, she asked a friend to take her home. When they arrived she passed out and stopped breathing. The friend performed CPR and called an ambulance. Karen quickly fell into a coma and lapsed into a persistent, vegetative state. After six months Karen’s parents asked for her to be taken off the respirator that was keeping her alive. Because of the lack of an Advance Directive the doctors refused, worried about committing murder under New Jersey law and a court battle ensued. This case went all the way to the New Jersey Supreme Court and, ‘The New Jersey Supreme Court affirmed a right to refuse medical treatment, a respirator in the case of Karen Quinlan, and held that this right was a constitutional right which could be exercised for an incompetent patient through the ‘substituted...