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Can an Advance Directive Be Overridden by Family Members or Health Care Providers?
It is possible for an advance directive to be overridden by family members and healthcare providers under certain circumstances. Advance directive violations can subject healthcare providers to serious consequences due […]
It is possible for an advance directive to be overridden by family members and healthcare providers under certain circumstances. Advance directive violations can subject healthcare providers to serious consequences due to liability, but this does not always prevent them from overriding them. Common examples of scenarios involving advance directive overrides can include:
- A family member selected as a surrogate decision maker makes a decision for care that conflicts or disregards what is stated in the advance directive
- The healthcare provider administered life-extending treatments that were forbidden in the directive
- The medical team was unaware that an advance directive existed
- The healthcare provider believed it was in the patient’s best interest to ignore the instructions in the directive
Healthcare providers are discouraged from violating advance directives; however, they have the legal right to choose not to comply with the directive instead. If the healthcare provider does not comply, they are responsible for transferring the patient to another healthcare provider who will honor the patient’s wishes.
Although medical teams generally make every effort to provide care that is aligned with patient wishes and values, mistakes and intentional violations can still happen. A study from 2020 found that 38% of patients with treatment-limiting Physician Orders for Life-Sustaining Treatment (POLSTs) received intensive care that was contradictory to their indicated preferences.
If a family member is appointed as a health care agent, they are responsible for making decisions regarding their loved one’s care if they are incapacitated and unable to make decisions for themselves. The expectation is for the health care agent to make decisions that are aligned with the wishes that have been outlined in the advance directive. However, the agent may, at times, make decisions that conflict with an advance directive, especially one that is ambiguous or out-of-date. Due to the nature of the decisions being made, it is always best to carefully select a health care agent since they will have the most authority in making decisions in a life-or-death situation.
Sources
“Can Family Overrule an Advance Directive? What You Need to Know”. Trustworthy. https://www.trustworthy.com/blog/can-family-overrule-an-advance-directive
