An Advance Directive in Two Questions

It has been two decades since advance directives have become an integral part of health care. Impediments to their optimal usage are common and multifactorial. Decisions commonly have to be made when patients are unable to do so or choose not to participate in decision making, often at the end of life. The use of two questions, 1) "If you cannot, or choose not to participate in health care decisions, with whom should we speak?" and 2) "If you cannot, or choose not to participate in decision making, what should we consider when making decisions about your care?," may accomplish the major goals of an advance directive. J Pain Symptom Manage 2011; 41: 801-807. (c) 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.