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The encouragement to complete an advance directive, above, is increasingly important. A recent study published in the April 1st edition of the New England Journal of Medicine emphasized that advance directives are indeed effective in ensuring that one's wishes are honored. Many studies also indicate that the more detailed and complete your advance directive, the more likely your wishes will be followed. Free state-standard advance directives for immediate download can be easily obtained (see: LifecareDirectives dot com). However, extensive research has demonstrated that there are significant drawbacks to using a standard state advance directive. As one research group noted, “...the development of statutory forms occurs in the legislative arena, [so] their content is the result of a political rather than a ‘scientific’ process,” and because of “political compromise, ...many of the forms ultimately passed by the legislatures are not optimal from a consumer perspective” (see: Hoffmann, DE; etal. The dangers of directives. Journal of Law, Medicine & Ethics. 1996;24(1)(Spring):5-17). The American Bar Association agrees, noting: “The statutory advance directive is not necessarily the exclusive, or even the best, pathway for individuals to follow,” and suggests that alternative documents “may be especially helpful as a...replacement for statutory forms where restrictions in a statutory directive prevents the individual from fully expressing his or her wishes” (see: American Bar Association, Patient Self Determination Act State Law Guide, 1991). One comprehensive directive is the Lifecare Advance Directive (see LifecareDirectives dot com). Another popular alternative advance directive is the Five Wishes living will (see: AgingWithDignity dot org). Both are valid for use in California. The Center for Practical Bioethics also offers a useful planning workbook (see PracticalBioethics dot org). Readers might want to explore these available documents further, as the choice of the document used can be very important indeed. Individuals should be encouraged to use the documents that best suit their needs and personal life goals. Doing so can save a great deal of unnecessary suffering and greatly reduce the burdens that families experience at these very difficult times, as well.
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