The introduction in Britain of advance directives-which allow a person
to state in advance of becoming incompetent that they wish to take pa
rt in treatment decisions when no longer mentally competent-has now be
en advocated by the medical and legal establishments. The practical ap
plication of directives relating to health care would be simplified by
the adoption of a standard model document together with guidelines su
mmarising the background clinical conditions and any subsequent acute
events that may make it appropriate to trigger the use of a directive.
As no specific legislation exists, good communication is needed at th
e various stages between the drafting and implementation of directives
if the system of directives is to be successful.