- advance d. a legal document giving instructions as to the type and degree of medical care to be administered in the event that the person signing the document becomes mentally incompetent during the course of a terminal illness, or becomes permanently comatose (persistent vegetative state).State legislatures have enacted so-called Death with Dignity laws to protect the rights of patients to refuse medical care, including life-prolonging and palliative care in terminal illness, as well as to clarify the role of physicians and indemnify them against the accusation of euthanasia or physician-assisted suicide when they withhold such care in compliance with patients' wishes. These laws spell out strict procedural requirements, including the need for the signing of an advance d. to be duly witnessed, and make it easier to revoke an advance d. than to establish one. When an advance d. provides instructions for the types of care the patient does or does not want to receive, it is known as a living will. When it names another person to make such decisions, it is known as a durable power-of-attorney for health care decisions. An advance d. can contain both types of instruction. An agent making end-of-life decisions on behalf of a patient is required to follow the patient's instructions, interpreting them when necessary in the light of the patient's personal philosophy, religious beliefs, and ethical values, and with due consideration for the likelihood that the patient will regain competency or will recover.
* * *di·rec·tive də-'rek-tiv, dī- adj of or relating to psychotherapy in which the therapist introduces information, content, or attitudes not previously expressed by the client
Medical dictionary. 2011.
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