Which statement about advanced directives is accurate?

• A. Incompetent individuals cannot make Advanced Directive decisions on behalf of themselves.
• B. Competent individuals cannot make their own decisions about advance directives.
• C. Advanced directives are only for end-of-life care in hospice.
• D. Advanced directives require approval by a physician.

Answer: (A)

Understanding advance directives hinges on capacity to make decisions. An advance directive is created by a person while they are competent to express their medical preferences for future situations when they may no longer be able to communicate. Because capacity is required to create one, someone who is incompetent cannot make an advance directive for themselves. In such cases, a surrogate decision-maker or guardian steps in, guided by any prior directives the person established or by substituted judgment.

This is why the statement is accurate. The other ideas aren’t correct: capable individuals can decide for themselves about advance directives, so the notion that they cannot is false; advance directives aren’t limited to end-of-life care or hospice and cover broader medical decisions; and they typically don’t require formal approval by a physician—health care providers follow and honor the documented wishes, though clinicians may help with creation and implementation.