Should the Law Be Out of Advance Directives?

I saw a blurb for an article in the New England Journal of Medicine that may be of interest to you.  Delegalizing Advance Directives — Facilitating Advance Care Planning is available to subscribers only.  Here’s the synopsis of the article: “Legal formalities impose barriers to creating advance directives. Eliminating legal requirements would allow such documents to be more easily integrated into health care systems and would increase the likelihood of their being used to achieve their intended goals.”

The article makes 3 arguments opposing the law with advance directives. First-the legal formalities imposed under the law discourage people from creating advance directives. Second-the law inhibits the involvement of technology with end of life planning (the article gives the example of the law requiring a signature; would an electronic signature suffice?) Third, the law refocuses end of life planning from the patient and doctor to the client and lawyer.

The article discusses how to make the changes suggested, when lawyers might be involved in planning, anticipates objections to the authors’ proposal and compares advance directives to other documents such as POLST or pre-hospital DNRs.

The article has generated a discussion on the NAELA listserv (for NAELA members) with opposing viewpoints offered. I can’t speak to legal formalities in other states, but in my state, it seems that it is fairly easy for someone to make an advance directive. The form in the statute is suggested and it is easy to use (in my opinion). It seems as though there are lots of programs to help people with their planning, such as 5 Wishes,  Caring Info , The Conversation Project to name a few (just Google “advance care planning” and see the number of results you get). For those of us who teach, this could be an interesting class discussion, so tuck this idea away in your folder for the fall semester!