However, autonomous behavior has the constraint of not causing harm to others. Likewise, a person who is not capable of self-governance is not able to act with autonomy. Examples would be a person with mental impairment due to Alzheimer's disease, or a stroke victim who lies in a coma. These are persons who lack the ability to make decisions for their own care. Thus a geriatrician must work to ensure the protection of autonomy through Advance Directives in preparation for future decision-making.
Many states including Ohio have a generic form for living wills.
However, individuals may write their own or have an attorney draft a document outlining their wishes. It is called durable because the person serving as power of attorney maintains the authority to manage a patient's affairs after that patient is no longer capable of doing so. A regular power of attorney loses its power when its grantor is no longer capable of directing the surrogate. Ohio has two types of durable power of attorney. A plain DPOA appoints a surrogate to handle all business, financial, and legal matters.