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Advance Directives (cont.)

Inability to Make Medical Decisions

Advance medical directive becomes effective only when a patient is no longer able to make their own decisions due to mental incapacity. This could be temporary or permanent. If temporary, the patient resumes decision making responsibilities once the temporary condition resolves.

Common situations in which a person may be temporarily or permanently unable or incapable of making complex judgment or end of life decisions are

  • coma (from any cause);
  • stroke (if it results in coma or cognitive deterioration);
  • moderate or severe dementia (Alzheimer's or other types);
  • persistent vegetative state;
  • severe illness requiring placement on breathing machine and inability to communicate;
  • severe medical conditions such as advanced liver failure or kidney failure;
  • traumatic brain injury resulting in the inability to make complex decisions.

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