2010 Apr 1 – NEJM Editorial: Reversing the Code Status of Advance Directives?

Muriel R. Gillick, M.D. Volume 362:1239-1240 April 1, 2010 Number 13
Twenty years ago, Congress passed the Patient Self-Determination Act, hoping to improve end-of-life care through the use of advance directives. The statute stimulated the development of a cornucopia of planning documents.


Patients can sign a living will that states that they do not want their lives prolonged if they are terminally ill. They can complete an instructional directive that specifies, for each of several clinical scenarios, which listed medical interventions they would want. They can fill out a values history, describing what they care most about, or they can designate a surrogate decision maker to speak on their behalf if . . .

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