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When Advance Directives Are Ignored

When Advance Directives Are Ignored

Do Advance Directive (AD) websites comply with State Laws?

The number of well-intended websites that help individuals and caregivers create advance directives seems to be growing on a monthly basis.   Do these websites create legal documents?

The laws governing advance directives vary from state to state, so it is important to complete and sign advance directives that comply with your state's law.   Also, advance directives can have different titles in different states.  One state’s advance directive does not always work in another state. Some states do honor advance directives from another state; others will honor out-of-state advance directives as long as they are similar to the state's own law; and some states do not have an answer to this question. The best solution is if you spend a significant amount of time in more than one state, you should complete the advance directives for all the states you spend a significant amount of time in.  Source

The AHRQ Report on Decision Aids for Advance Care Planning clearly states “As state law governs almost all issues related to end-of-life care, content of decision aids for ACP should be consistent with a state’s laws and regulations. For example, some states require that in order for a proxy to have authority regarding withholding or withdrawing a feeding tube, that preference must be explicitly stated in a healthcare directive, while other states grant a proxy discretion on that issue. Thus, an excellent decision aid for use in one state may mislead a patient’s effort to document preferences in another state. “

One site, DoYourProxy.org, at least informs / warns users that “Certain states require specific forms and/or specific statements to be included in their advance directive forms, and the forms generated here do not meet these requirements.”

Other sites seem to completely ignore the state law issue and are creating documents that are not legal.

I have also seem the rapid generation of “state forms” that have been copied from site to site, and one that just recently communicated that they now have state forms is using documents created in 2004! State laws change a lot and a document that has not been update for a decade might be at risk.

How do these well intended Advance Directive (AD) websites improve to meet the state law challenge?