An Advance Medical Directive is probably one of the most important documents a person can have as part of their estate planning package because it provides an active voice for their preferences during his or her lifetime during a time when they may not be able to express these preferences themselves. Another primary benefit of having an Advance Medical Directive in place is that it may avoid the necessity of having a guardian appointed for a person to make health care decisions when he or she begins to lack capacity. Initiating a guardianship proceeding in Maryland or the District of Columbia can be a costly and often lengthy proceeding.