According to several recently released studies, health care proxies and medical directives have done little or nothing to change the care provided to patients at the end of life.
Hospitals still provide more medical care and less pain treatment than patients want.
Doctors are often unaware that their patients have executed medical directives. Most medical institutions, both hospitals and nursing homes, have misinterpreted the Patient Self-Determination Act which requires them to inform patients of their rights under state law to execute medical directives. Instead, they seem to think that the law requires all patients to execute a medical directive or health care proxy or power of attorney, often making the signing of the instrument part of the admissions process. Now Every estate plan should include a medical directive. The form of the instrument will vary, depending on state law.