In social work, what are advance directives and outcomes?

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Tamara K. H. | Middle School Teacher | (Level 3) Educator Emeritus

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An advance directive, also more specifically called an advance health care directive, living will, or personal directive, is a legal document in which a person enumerates what actions he/she wants taken should he/she become unable to make decisions due to illness or other reasons.

The living will was devised by attorney Luis Kutner based on existing estate law geared towards protecting a person's property after death. Only, in the case of the living will, the document is geared towards protecting one's self as one's own property, while still living, in the event one is no longer able to make decisions. A living will specifically gives directives, or directions, about what kind of medical treatment the individual does or does not want to receive. A living will may specify that the person does not want to be resuscitated in the event of near death, be put on life support, or be fed through tubes. Directives in a living will can be either specific or very general. An example of a general living will directive is, "'If I suffer an incurable, irreversible illness, disease, or condition and my attending physician determines that my condition is terminal, I direct that life-sustaining measures that would serve only to prolong my dying be withheld or discontinued" ("Advance Health Care Directive").

There are even second generation and third generation advance directives. Second or next generation directives are legal documents based on existing power of attorney statutes. Using power of attorney, someone can legally grant another person the right to act on his/her behalf. Similar to power of attorney, a legal document allows an individual to name someone to make healthcare decisions for that person in the event the person is incapable of making the decision. Third generation advance directives are legal documents detailing an individual's values with the intention of helping "appointed agents, families, and physicians to better understand and honor [the individual's] wishes" ("Advance Health Care Directive"). Third generation advance directives were established as a means of moving away from specific medical treatments and rather focusing on a patient's personal values and goals, like spiritual goals.

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