Mandatory Advanced Directives?

[lucky1RN]

So after spending another grueling weekend trying to assist a patient and family through the dying process with no advanced directives, I have an idea.

What if advanced directives were required? What if you couldn't get or renew a driver's license without completing some form of and advanced directive? It could be something as simple as the Five Wishes document distributed by www.agingwithdignity.org. I'm not saying it would have to be tied in with a driver's license but was trying to think of some way for states to enforce mandatory advanced directives. I thought about having it a requirement for hospital admission but don't feel the timing would be ideal.

I am very very familiar with how difficult it is for people to come to terms with their own death but think it's extremely cruel and irresponsible NOT to prepare. If you don't make the decisions ahead of time, your family is left trying to guess what it is you would want done. When families disagree, arguments can ensue that irreversibly damage family relationships. That's why every time I have the chance, I encourage the family members of my terminal patients to prepare their advanced directives.

Anyway, what do you think Allnurses? How would you feel if advanced directives were state or federally mandated from a personal and professional perspective? Any ideas about how the government (as much as I hate to get the government involved) could enforce mandatory advanced directives? Do you think it would be better to just organize/lobby/legislate for awareness about advanced directives?

Thanks!!!

[CoffeeRTC, BSN, RN]

How often would you update them? We always ask at admission if they have advanced directives and then make the resident/ family sign a code status. If they don't want to make the decision then, they are aware that they will have CPR started and a code started. The only problem with this it that when the condition changes, sometimes this part is overlooked and people who maybe should be a full code on admit, shouldn't be now. KWIM?

[lucky1RN]

The only problem with this it that when the condition changes, sometimes this part is overlooked and people who maybe should be a full code on admit, shouldn't be now. KWIM?

Thanks for your reply Michelle.

Ya, I guess that's more what I mean...not just full code vs DNR but at least some coverage for the "what if" situations. The majority of my patients (I work ICU) are not capable of communicating and the code status decisions are left to their family members/next of kin. Without an advance directive, this can lead to some pretty heated discussions!