Medical decision-making at the end of life is increasingly becoming a matter of public policy, especially in developed countries with aging populations and rising incidence of chronic diseases.1 The progress and proliferation of medical technology in critical care allows physicians to provide more options to their patients in the resolution of these cases. At the same time, the growing emphasis on human rights and quality of life allows patients to take a greater role in deciding how their cases will be resolved. While such life-or-death decisions are not easily made under any circumstances, the situation is
further complicated when a patient is not capable of participating directly in the decision-making process. A properly executed advance health care directive (AD) by the patient would, in theory, alleviate much of the uncertainty that often paralyzes physicians and family members (or other surrogate decision-makers) and facilitate the resolution that best reflects the patient’s true wishes.2 Accordingly, policy-makers have a compelling interest in encouraging the use of ADs in clinical settings.