Advance Directives are our wishes when we are at end of life stages of life that give specific direction of how, who, and when to treat us in our final days and hours. We can have documents drawn up to say what we want in the event we are in a state where we cannot voice our wishes aloud. These documents have legal and ethical basis, and they should be followed unless the legally or ethically unable to do so.
Advance Directives gives a documented guide to the care giver’s or family member’s, so that they all can provide the kind of care that the medically impaired patient wants. This covers a wide variety of medical treatments such as dialisis, ventilators, feeding tubes and organ and or tissue transplants. If a patient has kidney failure they might or might not want to be on dialysis. The advance directive would spell out whether the patient would want such treatment if he or she was not able to convey this to the medical personnel. If the patient was at the end of life and did not want to be kept alive via artificial means such as a ventilator of feeding tube, the advance directive would have the patients wants of this type of treatment also. If the patient passed away and wanted his or her organs donated, then this directed would defanitely give the right to have their organs harvested and donated to someone in need. Even though there might be an advanced directed for a patient that is not able to express their wishes to their family or care givers, there can still be some legal and ethical issues with the wishes of the patient. First, the patient family and the physician need to know if there is an advance directive and or living will for the patient. Too many times the physician and the patient family does not know that there is a direction that the patient want to go in but no one else knows. In making an advance directive and or living will the patient must involve the healthcare provider and at least one family member, so more than one person will know what the patient wishes are at the necessary time. The patient must also have a copy of the advance directive or will placed in his or her medical file, therefore when the time comes a document will be on hand when it is needed. The doctor and or family must react in a timely manner so that the wishes of the patient are met in a timely manner. It is critical that the advanced directive and or living will are located at the time of critical need so that all the treatment and procedures can or cannot be done at the proper time requested. The language in the document must be clear and concise.
The document must spell out at what point and time should quality of care and the extending of life be altered. If the patient does not want to be on a feeding tube just to sustain their life, then a time period needs to be specific in the document so that the tube isn’t in longer than the patient had wished. If the document is not specific the doctor and or family members who may be too distraught to make decisions for the patient, may not be for filling the wishes of the patient who did not clearly specify those wishes in the document. A living will is a legal document expressing a person’s medical wishes to prolonging medical treatments at the end or near the end of life. A living will is very different from a living trust which distributes ones assets after death. A living will spells out how long and by what means a person wants there life extended in the event they are at life’s end. The living will does not become binding until the patient is incapacitated and must be certified by his or her physician. The living will is only there for when there when the life can be prolonged and not saved such as terminal illness. An example of a living will can be found below.

Kevin T. Britton Living Will

I, being of sound mind and at least 18 years of age, declare that:
(1) END-OF-LIFE DECISIONS: I direct that my health care providers and others involved in my care provider, withhold, or withdraw treatment in accordance with the choice I have marked below: (Initial only one box)
• [___] (a) Choice NOT To Prolong Life. I do not want my life to be prolonged if (1) I have an incurable and irreversible condition that will result in my death within a relatively short time, (2) I become unconscious and, to a reasonable degree of medical certainty, I will not regain consciousness, or (3) the likely risks and burdens of treatment would outweigh the expected benefits, OR
• [_KB__] (b) Choice to Prolong Life. I want my life to be prolonged as long as possible within the limits of generally accepted health care standards.
(2) RELIEF FROM PAIN: Except as I state in the following space, I direct that treatment for alleviation of pain or discomfort should be provided at all times even if it hastens my death: ____________KB______________________________________________

_____________ ____________________________________________________________

___________ ____________________________________________________________

___________.
(3) OTHER WISHES: (If you do not agree with any of the optional choices above and wish to write your own, or if you wish to add to the instructions you have given above, you may do so here.) I direct that: ____________________________________________________________

___________ ____________________________________________________________

___________ ____________________________________________________________

___________
(4) PRIMARY PHYSICIAN - (OPTIONAL).
• I designate the following physician as my primary physician:________DR. BUCK JAMES_________________________ (name of physician) ____1678 N. 52nd st. _Apopka, Florida, __________32711
• ___________________________________________________ (address) (city) (state) (zip code) ___________407-998-0090______________________ (phone) OPTIONAL: If the physician I have designated above is not willing, able, or reasonably available to act as my primary physician, I designate the following physician as my primary physician:
• ___Donald K. Gilmore______________________________ (name of physician) ________________6689 cresent bay cir. Suite 665 Orlando, Florida ,32788 __________________________________________________ (address) (city) (state) (zip code) __________4078679988 _______________________ (phone)
(5) DONATION OF ORGANS AT DEATH - (OPTIONAL).
Upon my death: (mark applicable box)
• [_kb__] (a) I give any needed organs, tissues, or parts, OR
• [___] (b) I give the following organs, tissues, or parts only.
• [___] (c) My gift is for the following purposes: (strike any of the following you do not want)
X (1) Transplant o (2) Therapy o (3) Research o (4) Education
In the absence of my ability to give directions regarding the use of such life-sustaining procedures, it is my intention that this declaration shall be honoured by my family and physician(s) as the final expression of my legal right to refuse medical or surgical treatment, and I accept the consequences from such refusal.
I understand the full import of this declaration and I am emotionally and mentally competent to make this declaration.
I execute this declaration, as my free and voluntary act, on this _16th_____ day of __October_____________, 2010, in the City of Apopka, County of Orange, and State of Florida.
______________________________________
(INSTRUCTIONS: This advance health care directive will not be valid for making health care decisions unless it is either: (1) signed by two (2) qualified adult witnesses who are personally known to you and who are present when you sign or acknowledge your signature; or (2) acknowledged before a notary public.)
I declare under penalty of perjury under the laws of the state of (1) that the individual who signed or acknowledged this advance health care directive is personally known to me, or that the individual's identity was proven to me by convincing evidence, (2) that the individual signed or acknowledged this advance directive in my presence, (3) that the individual appears to be of sound mind and under no duress, fraud, or undue influence, (4) that I am not a person appointed as agent by this advance directive, and (5) that I am not the individual’s health care provider, an employee of the individual's health care provider, the operator of a community health care facility, the operator of a community health care facility, the operator of a residential care facility for the elderly, nor an employee of an operator of a residential care facility for the elderly.
I further declare under the laws of penalty of perjury of the state of that I am neither related to the patient by blood, marriage, or adoption, and, to the best of my knowledge, I am not entitled to any portion of the patient's estate upon the patient's death under a will existing when the advance directive is executed or by operation of law.
Signed at ___Health Central_____________, on this _16___ day of __October____________, 2010. _________Samuel A. Britton ____________________________________________________ (Name and address of first witness) Ann S.Britton_____________________________________________________

___ (Name and address of second witness)
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State of _Florida_________________ ) )
County of _Orange________________ )

On this the ____16____ day of October__________________, 2010, before me, the undersigned, a notary public in and for said County and State, personally appeared _Health Central Medical staff , personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal. ____________________________________ Signature of Notary