In the last issue of Experience (Vol. 22, No. 2, 2013), Dr. Daniel Brauner addressed the background of advance directives. He provided a concise summary of these instruments and their histories, and he advised that attorneys can be most helpful to clients by focusing their efforts on identifying decision makers who can act as healthcare agents if and when a client loses the capacity to make his or her wishes known. He also touched on the growing trend in medical care to have “goals of care” discussions and warned against the dangers of premature “Do Not Resuscitate” (DNR) orders. Dr. Brauner’s points are well taken. However, I would like to expand on some of the issues he raised in order to provide additional guidance for attorneys who work with older clients. I would also like to weigh in on his discussion of the optimal timing for creation of advance directives and to explain why I believe that people may wish to create an advance directive at an earlier point in the healthcare planning process, rather than a later one, as Dr. Brauner suggests.
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