Advance directives in emergency medicine: Medical, legal, and ethical implications

The history of the patient's right to refuse treatment as it applies to resuscitative medical care is reviewed, as are the various types of advance directives, including the living will and durable power of attorney and their clinical uses.

Abstract

Emergency physicians often encounter clinical situations in which medical resuscitation may not coincide with patient expectations. These situations present complicated medical, legal, and ethical dilemmas. The history of the patient's right to refuse treatment as it applies to resuscitative medical care is reviewed. Medical recognition of patient autonomy and legal precedents affirming it are discussed, as are the various types of advance directives, including the living will and durable power of attorney and their clinical uses.