What are medical advance directives?

Medical advance directives allow another, trusted individual to make decisions in the event a person is incapable of making it themselves. 

Understanding medical advance directives

Medical advance directives are legal documents that allow people to express their medical preferences for care when they cannot make decisions for themselves. The directives usually contain a living will and the powers of attorney for healthcare. The document will generally outline the type of medical treatment a person does or does not want, like life support or resuscitation. 

A power of attorney designates the person responsible for making healthcare decisions on the patient's behalf if the individual becomes incapacitated. The advance directive should protect patient autonomy so that medical care aligns with the patient's values and desires. In the context of legislation, laws like the Patient Self Determination Act and HIPAA provide for a patient's rights in this situation. 

A special article published in The New England Journal of Medicine said, “Most state legislatures have recently passed statutes on these issues. Forty-seven states and the District of Columbia now have laws covering living wills, durable powers of attorney, or both, 25 of them enacted in the past five years. The recent Supreme Court decision in the case of Nancy Cruzan emphasized the need to provide "clear and convincing evidence" of the incompetent patient's earlier wishes.”

How to securely share medical directives 

Creating and storing digital copies of medical directives can be helpful for future reference. From being easily accessible, it can also be transferred with the press of a button. The steps to share these medical directives easily include: 

• Use secure methods of sharing directives like HIPAA compliant email services to protect data in transit. 
• Store directives in a HIPAA compliant cloud storage service. Make sure to have a BAA with this vendor and any other, as needed. 
• Register directives with specialized state or private advance directive registries that provide authorized access to healthcare providers. 
• Avoid transferring directives and other electronic protected health information (ePHI) to unsecured USB drives. 
• Maintain secure physical security policies to protect the devices on which directives and other ePHI are accessible.

FAQs

What is PHI? 

PHI is any health-related information that can identify a person, like medical records, billing details, and demographic data. 

What is consent? 

The explicit permission given by a patient for medical treatment or the use and sharing of their PHI. 

What is the difference between a psychiatric and a medical directive?

A psychiatric advance directive relates to mental health while a medical advance directive covers general healthcare decisions.