Description
Advance directives afford competent patients an opportunity to express their preferences towards medical treatment in the event of them becoming incapacitated. In the United Kingdom they hold a limited legal standing. Their broad non-specific nature can make their application difficult in many situations, taxing the clinician wishing to do what is best for the patient. Disease-specific advance directives may help resolve matters in some cases but in the critical care setting advance directives are of restricted value. Intensivists bring their expertise to clinical situations a patient may have never envisaged. They are trained to look for established preferences of care. This is often achieved through ongoing dialogue with relatives, carers and where possible the patient, rather than by documentation alone.
