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I have changed my mind about my advance directives:what should I do?

I have changed my mind about my advance directives:what should I do?

Any adult has the possibility of expressing their wishes as to the course and especially with regard to the care of their end of life by writing their advance directives. The latter are imposed, except under certain specific conditions, on the medical profession if you are suffering from a serious and incurable illness. Advance directives have an unlimited duration once they are written, but they can be modified or canceled at any time.

What are advance directives? What are they for ? How to write them?

Advance directives designate a written document that any adult can write to indicate their wishes with regard to the course of their end of life. A person is considered to be at the end of life if they have a serious and incurable condition in the advanced or terminal phase.

If you no longer have the possibility of expressing your wishes at that time in your life, due to a serious illness or an accident, for example, your advance directives allow doctors to adapt their care in accordance with your previously communicated wishes, which are binding on them in the presence of advance directives.

By writing your advance directives, you have the possibility of expressing wishes for your end of life, such as your desire to limit or stop the treatments that will be prescribed to you, to be relieved of your suffering even if the care provided can cause your death, agree to be transferred to intensive care if your state of health requires it, be put on artificial respiration, or even indicate your authorization to undergo surgery if necessary.

However, doctors have the option of overriding your advance directives in two cases. In the event of a life-threatening emergency or if the advance directives appear to them to be "manifestly inappropriate or not in accordance with the medical situation".

Advance directives must take the form of a document written on plain paper that you must date and sign. Your attending physician can advise you on how to write it. Otherwise, the Ministry of Solidarity and Health provides models of advance directives on its website depending on whether you are in good health at the time of writing them, or suffering from a serious illness.

If it is not possible for you to write your advance directives yourself, you can have recourse to your person of trust to write them for you, a person of trust being a relative whom you have designated to carry out missions such as that you attend medical appointments, express your wishes to the medical profession if you are unable to do so, etc. In this case, another witness must attend the drafting of your advance directives by your trusted person.

How to modify or cancel advance directives?

It is important that your relatives or the medical profession are aware of the existence of your advance directives if your state of health no longer allows you to express your own wishes for your end of life. You must therefore, beforehand, tell those around you, or your attending physician, where your advance directives are kept so that you can find them easily when the time comes.

Your advance directives can, for example, be kept in your medical file with your doctor, be entrusted to the hospital or specialized establishment for the elderly where you live, to your trusted person, to a member of your family or to a close. Your advance directives can also be recorded in your personal shared medical file, a computerized and secure health record, if you have created it. If you keep your advance directives at home, remember in advance to indicate where they are stored to those around you.

From the moment they are written, advance directives have an unlimited duration. However, it is quite possible to modify them, or even cancel them, at any time.

If you have changed your mind about your advance directives, you must write new ones under the same conditions as the first time, and in particular respect the rules to be applied according to your state of health. The Ministry of Solidarity and Health also provides a model form on its website to modify or cancel your first advance directives.

If you write new advance directives, you should ask your doctor, the institution for the elderly where you live, your doctor, etc., i.e. the person or organization that holds your advance directives to destroy the first ones that you wrote and for which you changed your mind.

Note:in the presence of several documents indicating your advance directives, the most recent is the one that is taken into account. This is particularly the case if you have recorded your wishes regarding your end of life in your shared medical file where you can record your new advance directives, but not delete the old ones.