[EternalVigilance]

The problem is that 80% or more of persons who execute "advance directives" revoke them when they are sick (i.e., they change their minds). If people under 40 all made advance directives, this number would be 95%+.

Therefore, respecting someone's "wishes" without regard to the clinical scenario is incompetent at best, if not negligent.

It is not obvious that brain-injured persons (who cannot "change their mind") should be held to the letter of their "prior wishes", since those prior wishes in expressive patients have almost no substance.

Very good, very important post.

[Jim Noble]

Thanks very much.

I should also point out that the Feds and other interested parties are very anxious for healthy young people to execute advanced directives (it may become mandatory soon).

The universal healthy young person advanced directive is, "If I'm ever sick, kill me" (it's a cultural thing).

You can bet that the payers, including the Feds, are going to want to "respect the patient's wishes", expressed at age 25, when they are old and sick.