What do you do when the advance directive doesn't make sense?

The wait was too long.  We had to change plans. I arrived home late after a long day at work and my wife asked if I wanted to go to that new restaurant everyone had been talking about.  We hopped into the car and drove off, not really thinking about a reservation.  We both groaned when the restaurant came into sight and we saw throngs of people waiting outside.  "Maybe it's not as bad as it looks," I said as I jumped out of the car to check, only to find out there was a 90 minute wait.  As I walked back to the car, I had already made up my mind to go down the road to an old standby.  My wife readily agreed without any deliberation.  Relief of hunger superseded novelty as we made a restaurant selection. Of course, choosing a restaurant on a Friday night is nowhere near as complex as medical decision-making.  We had the opportunity to choose between two appealing restaurant options with guaranteed good conversation at either place. Patients sometimes choose between seemingly "bad" and "worse" options.  How might the decisions be similar, though?  When the rubber meets the road and we actually have to make a decision, the facts and assumptions surrounding the decision might have changed, which may affect the decision. Think of a 78 year old woman with advanced COPD recently referred to hospice.  She falls walking to the bathroom and fractures her proximal femur.  She presents to the emergency department and undergoe...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Carer Workers Authors: Source Type: blogs